Indications for treatment at relapse
| Type of relapse . | Indications . |
|---|---|
| Clinical relapse | Development of new soft-tissue plasmacytomas or bone lesions |
| • Definite increase (≥50%) in size of existing plasmacytomas or bone lesions | |
| • Hypercalcemia (≥11.5 mg/dL; 2.875 mmol/L) | |
| • Decrease in hemoglobin of ≥2 g/dL (1.25 mmol/L), or of <10 g/dL because of myeloma | |
| • Rise in serum creatinine by ≥2 mg/dL or more (≥177 mmol/L), due to myeloma | |
| • Hyperviscosity requiring therapeutic intervention | |
| Significant biochemical relapse in patients without clinical relapse | Doubling of the M-component in 2 consecutive measurements separated by 2 months with the reference value of 5 g/L, or |
| • In 2 consecutive measurements, any of the following increases: | |
| o the absolute levels of serum M-protein by ≥10 g/L, or | |
| o an increase of urine M-protein by ≥500 mg per 24 h, or | |
| o an increase of involved FLC level by ≥20 mg/dL (plus an abnormal FLC ratio) or 25% increase (whichever is greater) |
| Type of relapse . | Indications . |
|---|---|
| Clinical relapse | Development of new soft-tissue plasmacytomas or bone lesions |
| • Definite increase (≥50%) in size of existing plasmacytomas or bone lesions | |
| • Hypercalcemia (≥11.5 mg/dL; 2.875 mmol/L) | |
| • Decrease in hemoglobin of ≥2 g/dL (1.25 mmol/L), or of <10 g/dL because of myeloma | |
| • Rise in serum creatinine by ≥2 mg/dL or more (≥177 mmol/L), due to myeloma | |
| • Hyperviscosity requiring therapeutic intervention | |
| Significant biochemical relapse in patients without clinical relapse | Doubling of the M-component in 2 consecutive measurements separated by 2 months with the reference value of 5 g/L, or |
| • In 2 consecutive measurements, any of the following increases: | |
| o the absolute levels of serum M-protein by ≥10 g/L, or | |
| o an increase of urine M-protein by ≥500 mg per 24 h, or | |
| o an increase of involved FLC level by ≥20 mg/dL (plus an abnormal FLC ratio) or 25% increase (whichever is greater) |