MDCalc

Multiple Myeloma Diagnostic Criteria

Diagnoses multiple myeloma, according to the International Myeloma Working Group (IMWG).

≥1 of the following (A or B):

≥1 myeloma defining event (C1 or C2):

C1. End organ damage attributable to underlying plasma cell disorder (≥1 of the following):

Serum calcium >1 mg/dL (>0.25 mmol/L) higher than upper limit of normal or >11 mg/dL (>2.75 mmol/L)
Creatinine clearance <40 mL per min or serum creatinine >2 mg/dL (177 μmol/L)
Hemoglobin >2 g/dL (20 g/L) below lower limit of normal, or <10 g/dL (100 g/L)
≥1 osteolytic lesion on skeletal x-ray, CT, or PET-CT

C2. ≥1 of the following biomarkers of malignancy:

Diagnostic Result

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Advice
  • If the criteria are met:
  • If criteria are not met:
    • Monitor for progression in patients with smoldering myeloma or monoclonal gammopathy of undetermined significance (MGUS).
    • Consider and evaluate for other diagnoses.
    • Reassess if new symptoms or complications arise.
    • Provide patient education about symptoms that warrant re-evaluation.
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