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

多发性骨髓瘤 骨髓瘤蛋白 不确定意义的单克隆抗体病 医学 骨髓 等离子体电池 浆细胞增多 单克隆 浆细胞瘤 病理 单克隆抗体 免疫学 抗体
作者
Robert A. Kyle,J. A. Child,Kenneth C. Anderson,Bart Barlogie,Régis Bataille,William I. Bensinger,Joan Bladé,Mario Boccadoro,William S. Dalton,Meletios Α. Dimopoulos,Benjamin Djulbegović,Mark T. Drayson,Brian G.M. Durie,T. Facon,Rafaël Fonseca,Gösta Gahrton,Philip R. Greipp,Jean Luc Harousseau,D. Harrington,Mohamad A. Hussein,Douglas Joshua,Heinz Ludwig,Gareth J. Morgan,Martin M. Oken,R Powles,Paul G. Richardson,David Roodman,Jesús F. San Miguel,Kazuyuki Shimizu,Chaim Shustik,Bhawna Sirohi,Pieter Sonneveld,Guido Tricot,Ingemar Turesson,Brian G. Van Ness,David H. Vesole,Donna M. Weber,Jan Westin,Keith Wheatley
出处
期刊:British Journal of Haematology [Wiley]
卷期号:121 (5): 749-757 被引量:2219
标识
DOI:10.1046/j.1365-2141.2003.04355.x
摘要

Summary. 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/l 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/l and/or bone marrow clonal cells ≥ 10% but no r elated o rgan or t issue i mpairment (ROTI)(end‐organ damage), which is typically manifested by increased c alcium, r enal insufficiency, a naemia, or b one lesions (CRAB) attributed to the plasma cell proliferative process. Symptomatic myeloma requires evidence of ROTI. 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.
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