Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: A report of the International Myeloma Working Group

Robert A. Kyle, J. Anthony Child, Kenneth Anderson, Bart Barlogie, Regis Bataille, William Bensinger, Joan Bladé, Mario Boccadoro, William Dalton, Meletios Dimopoulos, Benjamin Djulbegovic, Mark Drayson, Brian Durie, Thiery Facon, Rafael Fonseca, Gosta Gahrton, Philip Greipp, Jean Luc Harousseau, David Harrington, Mohamad HusseinDouglas Joshua, Heinz Ludwig, Gareth Morgan, Martin Oken, Raymond Powles, Paul Richardson, David Roodman, Jesus San Miguel, Kazuyuki Shimizu, Chaim Shustik, Bhawna Sirohi, Pieter Sonneveld, Guido Tricot, Ingemar Turesson, Brian Van Ness, David Vesole, Donna Weber, Jan Westin, Keith Wheatley

Research output: Contribution to journalReview article

1718 Scopus citations

Abstract

The monoclonal gammopathies are a group of disorders associated with monoclonal proliferation of plasma cells. The characterization of specific entities is an area of difficulty in clinical practice. The International Myeloma Working Group has reviewed the criteria for diagnosis and classification with the aim of producing simple, easily used definitions based on routinely available investigations. In monoclonal gammopathy of undetermined significance (MGUS) or monoclonal gammopathy, unattributed/unassociated (MG[u]), the monoclonal protein is < 30 g/1 and the bone marrow clonal cells < 10% with no evidence of multiple myeloma, other B-cell proliferative disorders or amyloidosis. In asymptomatic (smouldering) myeloma the M-protein is ≥ 30 g/1 and/or bone marrow clonal cells ≥ 10% but no related organ or tissue impairment (ROTI)(end-organ damage), which is typically manifested by increased calcium, renal insufficiency, anaemia, or bone lesions (CRAB) attributed to the plasma cell proliferative process. Symptomatic myeloma requires evidence of ROTL Non-secretory myeloma is characterized by the absence of an M-protein in the serum and urine, bone marrow plasmacytosis and ROTI. Solitary plasmacytoma of bone, extramedullary plasmacytoma and multiple solitary plasmacytomas (± recurrent) are also defined as distinct entities. The use of these criteria will facilitate comparison of therapeutic trial data. Evaluation of currently available prognostic factors may allow better definition of prognosis in multiple myeloma.

Original languageEnglish (US)
Pages (from-to)749-757
Number of pages9
JournalBritish journal of haematology
Volume121
Issue number5
DOIs
StatePublished - Jun 2003

Keywords

  • Classification
  • Gammopathies
  • Monoclonal
  • Multiple myeloma

ASJC Scopus subject areas

  • Hematology

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    Kyle, R. A., Child, J. A., Anderson, K., Barlogie, B., Bataille, R., Bensinger, W., Bladé, J., Boccadoro, M., Dalton, W., Dimopoulos, M., Djulbegovic, B., Drayson, M., Durie, B., Facon, T., Fonseca, R., Gahrton, G., Greipp, P., Harousseau, J. L., Harrington, D., ... Wheatley, K. (2003). Criteria for the classification of monoclonal gammopathies, multiple myeloma and related disorders: A report of the International Myeloma Working Group. British journal of haematology, 121(5), 749-757. https://doi.org/10.1046/j.1365-2141.2003.04355.x