Diagnostic criteria for plasma cell disorders
| Disorder/criteria . | Comment . |
|---|---|
| Monoclonal gammopathy of undetermined significance | All 3 criteria must be met |
| Serum monoclonal protein < 3 g/dL | |
| Clonal bone marrow plasma cells < 10% | |
| Absence of end-organ damage, such as hypercalcemia, renal insufficiency, anemia, and bone lesions, which can be attributed to the plasma cell proliferative disorder | |
| Smoldering multiple myeloma (asymptomatic multiple myeloma) | Both criteria must be met |
| Serum monoclonal protein (IgG or IgA) ≥ 3 g/dL and/or clonal bone marrow plasma cells ≥ 10% | |
| Absence of end-organ damage, such as lytic bone lesions, anemia, hypercalcemia, or renal failure, which can be attributed to a plasma cell proliferative disorder | |
| Symptomatic multiple myeloma | All 3 criteria must be met except as noted |
| Clonal bone marrow plasma cells ≥ 10% | |
| Presence of serum and/or urinary monoclonal protein (except in patients with nonsecretory multiple myeloma)* | |
| Evidence of end-organ damage, which can be attributed to the underlying plasma cell proliferative disorder, specifically | |
| Hypercalcemia: serum calcium ≥ 11.5 mg/dL | |
| Renal insufficiency: serum creatinine > 2 mg/dL | |
| Anemia: normochromic, normocytic with a hemoglobin value of > 2 g/dL below the lower limit of normal, or a hemoglobin value < 10 g/dL | |
| Bone lesions: lytic lesions, severe osteopenia, or pathologic fractures |
| Disorder/criteria . | Comment . |
|---|---|
| Monoclonal gammopathy of undetermined significance | All 3 criteria must be met |
| Serum monoclonal protein < 3 g/dL | |
| Clonal bone marrow plasma cells < 10% | |
| Absence of end-organ damage, such as hypercalcemia, renal insufficiency, anemia, and bone lesions, which can be attributed to the plasma cell proliferative disorder | |
| Smoldering multiple myeloma (asymptomatic multiple myeloma) | Both criteria must be met |
| Serum monoclonal protein (IgG or IgA) ≥ 3 g/dL and/or clonal bone marrow plasma cells ≥ 10% | |
| Absence of end-organ damage, such as lytic bone lesions, anemia, hypercalcemia, or renal failure, which can be attributed to a plasma cell proliferative disorder | |
| Symptomatic multiple myeloma | All 3 criteria must be met except as noted |
| Clonal bone marrow plasma cells ≥ 10% | |
| Presence of serum and/or urinary monoclonal protein (except in patients with nonsecretory multiple myeloma)* | |
| Evidence of end-organ damage, which can be attributed to the underlying plasma cell proliferative disorder, specifically | |
| Hypercalcemia: serum calcium ≥ 11.5 mg/dL | |
| Renal insufficiency: serum creatinine > 2 mg/dL | |
| Anemia: normochromic, normocytic with a hemoglobin value of > 2 g/dL below the lower limit of normal, or a hemoglobin value < 10 g/dL | |
| Bone lesions: lytic lesions, severe osteopenia, or pathologic fractures |
More than 10% clonal plasma cells are required for the diagnosis of nonsecretory myeloma.