title: International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma.
abstract: This International Myeloma Working Group consensus updates the disease definition of multiple myeloma to include validated biomarkers in addition to existing requirements of attributable CRAB features (hypercalcaemia, renal failure, anaemia, and bone lesions). These changes are based on the identification of biomarkers associated with near inevitable development of CRAB features in patients who would otherwise be regarded as having smouldering multiple myeloma. A delay in application of the label of multiple myeloma and postponement of therapy could be detrimental to these patients. In addition to this change, we clarify and update the underlying laboratory and radiographic variables that fulfil the criteria for the presence of myeloma-defining CRAB features, and the histological and monoclonal protein requirements for the disease diagnosis. Finally, we provide specific metrics that new biomarkers should meet for inclusion in the disease definition. The International Myeloma Working Group recommends the implementation of these criteria in routine practice and in future clinical trials, and recommends that future studies analyse any differences in outcome that might occur as a result of the new disease definition.
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN, USA. Electronic address: rajkumar.vincent@mayo.edu.
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.affiliation: Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
authors.affiliation: Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.affiliation: Hospital Clinic, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Blade
authors.affiliation: Amyloidosis Center, University Hospital Policlinico San Matteo, Pavia, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Merlini
authors.affiliation: University Hospital of Salamanca/IBSAL, Salamanca, Spain.
authors.forename: María-Victoria
authors.initials: MV
authors.lastname: Mateos
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Shaji
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Hillengass
authors.affiliation: Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Kastritis
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Richardson
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
authors.affiliation: Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Pamplona, Spain.
authors.forename: Bruno
authors.initials: B
authors.lastname: Paiva
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Dispenzieri
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Brendan
authors.initials: B
authors.lastname: Weiss
authors.affiliation: University Hospital of Lille, Lille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: LeLeu
authors.affiliation: Department of Hematology, VU University Medical Center, Amsterdam, Netherlands.
authors.forename: Sonja
authors.initials: S
authors.lastname: Zweegman
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
authors.forename: Sagar
authors.initials: S
authors.lastname: Lonial
authors.affiliation: Hospital Clinic, Barcelona, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Rosinol
authors.affiliation: Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Zamagni
authors.affiliation: Mount Sinai Cancer Institute, New York, NY, USA.
authors.forename: Sundar
authors.initials: S
authors.lastname: Jagannath
authors.affiliation: Memorial Hospital, Istanbul, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Sezer
authors.affiliation: Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sigurdur Y
authors.initials: SY
authors.lastname: Kristinsson
authors.affiliation: Department of Hematology, CHU de Liege, Liege, Belgium.
authors.forename: Jo
authors.initials: J
authors.lastname: Caers
authors.affiliation: Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, USA.
authors.forename: Saad Z
authors.initials: SZ
authors.lastname: Usmani
authors.affiliation: Servicio de Hematología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Lahuerta
authors.affiliation: Department of Haematology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Hans Erik
authors.initials: HE
authors.lastname: Johnsen
authors.affiliation: Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Beksac
authors.affiliation: Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.affiliation: Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Goldschmidt
authors.affiliation: Department of Clinical Therapeutics, University of Athens, School of Medicine, Athens, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Terpos
authors.affiliation: Division of Hematology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Anderson
authors.affiliation: Cedars-Sinai Comprehensive Cancer Center, Los Angeles, CA, USA.
authors.forename: Brian G M
authors.initials: BG
authors.lastname: Durie
authors.affiliation: Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), Pamplona, Spain.
authors.forename: Jesus F San
authors.initials: JF
authors.lastname: Miguel
mesh_terms: D014408:Biomarkers, Tumor; D001854:Bone Marrow Cells / Q000473:pathology; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D051437:Renal Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor