International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma

S. Vincent Rajkumar*, Meletios A. Dimopoulos, Antonio Palumbo, Joan Blade, Giampaolo Merlini, María Victoria Mateos, Shaji Kumar, Jens Hillengass, Efstathios Kastritis, Paul Richardson, Ola Landgren, Bruno Paiva, Angela Dispenzieri, Brendan Weiss, Xavier LeLeu, Sonja Zweegman, Sagar Lonial, Laura Rosinol, Elena Zamagni, Sundar JagannathOrhan Sezer, Sigurdur Y. Kristinsson, Jo Caers, Saad Z. Usmani, Juan José Lahuerta, Hans Erik Johnsen, Meral Beksac, Michele Cavo, Hartmut Goldschmidt, Evangelos Terpos, Robert A. Kyle, Kenneth C. Anderson, Brian G.M. Durie, Jesus F.San Miguel

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1910 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)e538-e548
JournalThe Lancet Oncology
Issue number12
Publication statusPublished - 1 Nov 2014

Bibliographical note

Publisher Copyright:
© 2014 Elsevier Ltd.


Dive into the research topics of 'International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma'. Together they form a unique fingerprint.

Cite this