International Myeloma Working Group (IMWG) Guidelines for Serum Free Light Chain Analysis in Multiple Myeloma and Related Disorders

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For the more than 3% of myeloma patients who have non-secretory or oligosecretory disease, and for the majority of patients with AL amyloidosis (AL), the traditional methods of measuring circulating monoclonal immunoglobulins (electrophoresis, immunoelectrophoresis, immunofixation electrophoresis, and nephelometric measurement of immunoglobulin heavy chains of serum) are not adequate. The development of an assay that measures serum immunoglobulin-free light chains has demonstrated utility for monitoring these patients and for other specific indications, such as monitoring heavily-pretreated patients at relapse. The following guidelines from the International Myeloma Working Group describe the potential uses of the serum free light chain (SFLC) assay and distinguish which uses have proved their utility and which are […]

International Myeloma Working Group (IMWG) Uniform Response Criteria for Multiple Myeloma

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The International Myeloma Working Group established the below criteria in order to: facilitate precise comparisons of efficacy between new treatment strategies in trials incorporate the serum free light chain (FLC) assay to include assessment of patients with oligo-secretory and non-secretory disease provide stricter definitions for CR (complete response) provide classifications that would improve detail and correct inconsistencies in prior response criteria. The following criteria reconcile various previously used systems for assessing response and have been universally adopted. Response IMWG criteria sCR CR as defined below plus normal FLC ratio and absence of clonal cells in bone marrow3 by immunohistochemistry or immunofluorescence4 CR Negative immunofixation on the serum and urine and […]