Multiple Myeloma Response Criteria

When to Use

Negative immunofixation of serum and urine AND disappearance of any soft tissue plasmacytomas AND <5% plasma cells in bone marrow

Criteria above plus normal FLC ratio (0.26-1.65) AND absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescence

Serum and urine M component detectable by immunofixation but not on electrophoresis OR ≥90% reduction in serum M component plus urine M component <100 mg per 24 hrs

≥50% reduction of serum M protein and reduction in 24 hr urinary M protein by ≥90% or to <200 mg per 24 hrs; if present at baseline, ≥50% reduction in the size of soft tissue plasmacytomas is also required

See Evidence for criteria if serum and urine M protein are unmeasurable

25% increase from lowest response value in the following (select any that apply):

Serum M component

Absolute increase must be ≥0.5 g/100 mL

Urine M component

Absolute increase must be ≥200 mg per 24 hrs

Only in patients without measurable serum and urine M protein levels: difference between involved and uninvolved FLC levels

Absolute increase must be >100 mg/L

Bone marrow plasma cell percentage

Absolute % must be ≥10%

Definite development of new bone lesions or soft tissue plasmacytomas or definite increase in the size of existing bone lesions or soft tissue plasmacytomas

Development of hypercalcemia that can be attributed solely to the plasma cell proliferative disorder

Corrected serum calcium must be >11.5 mg/dL

Diagnostic Result:

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Next Steps

Evidence

Creator Insights

Dr. Robert A. Kyle

About the Creator

Robert A. Kyle, MD, is a professor of medicine and laboratory medicine and pathology at the Mayo Clinic in Rochester, Minnesota. He is widely regarded as a pioneer in multiple myeloma research, having published numerous critical papers on topics including monoclonal gammopathies, multiple myeloma, amyloidosis, and macroglobulinemia.

To view Dr. Robert A. Kyle's publications, visit PubMed

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Multiple Myeloma Response Criteria

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