MULTIPLE MYLOMA

Diagnostic criteria

MAJOR criteria

Plasmacytoma on tissue biopsy

Bone marrow plasmacytosis ≥ 30%

M Protein: IgG > 3.5 g/L; IgA > 2.0 g/L

Urinary kappa or lambda chain excretion of > 1g / 24 hrs in absence of amyloidosis

MINOR criteria

Marrow plasmacytosis of 10-30%

Lytic bone lesions

Evidence of a monoclonal protein but lessor amounts than above

Hypoglobulinemia of normal proteins: IgM < 500 mg/L, IgA < 1 g/L or IgG < 6g/L

Diagnosis of MM is made by :

• One major plus one minor criteria OR• 3 or more minor criteria

PROGNOSIS

The tumor burden and the proliferation rate are the 2 key indicators for the prognosis in patients with MM. C-reactive protein (CRP) and beta-2 microglobulin are used to predict survival as follows:

54 months

• If levels of both proteins are less than 6 mg/L

27

• if the level of only one component is less than 6 mg/L

6 months

• If levels of both protein values are greater than 6 mg/L

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