“Our group, which includes more than 180 myeloma researchers worldwide, has updated the definition of multiple myeloma for diagnostic purposes to include validated biomarkers in addition to the current clinical symptoms used for diagnosis which include, elevated blood calcium levels, kidney failure, anemia and bone lesions,” said lead author S. Vincent Rajkumar, M.D. a hematologist at Mayo Clinic.
Dr. Rajkumar said multiple myeloma is always preceded sequentially by two asymptomatic conditions, monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM).
However, since MGUS and SMM are both asymptomatic conditions, most myeloma patients are not diagnosed until organ damage occurs. “The new IMWG criteria allow for the diagnosis of myeloma to be made in patients without symptoms and before organ damage occurs, using validated biomarkers that identify patients with SMM who have an “ultra-high” risk of progression to multiple myeloma,” Dr. Rajkumar said. “These biomarkers are associated with the near inevitable development of clinical symptoms and are important for early diagnosis and treatment which is very important for patients.”
Dr. Rajkumar said other updates to the criteria used to diagnose multiple myeloma include the use of CT and PET-CT scans to identify bone lesions which will enable more accurate diagnosis and intervention before fractures or other serious problems arise. “We believe that the new criteria will rectify the situation where we were unable to use the considerable advances in multiple myeloma therapy prior to organ damage. We can now initiate therapy in some patients early on in the course of their disease.”
Dr. Rajkumar said numerous investigators conducted the primary research that made the criteria update possible and that he is thankful for the support of patients and patient advocates whose stories and thoughts provided the impetus for this paradigm shift.