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Thread: Treatment criteria in MM

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    Default Treatment criteria in MM

    Multiple myeloma does not always require treatment. There are criteria regarding when to treat patients based on the degree of disease - the CRAB criteria. CRAB criteria means calcium elevation [hypercalcemia], renal insufficiency, anemia, or bone lesions.

    Calcium
    Elevated calcium or hypercalcemia over 1 mg/dL higher than the upper limit of normal (ULN) based on local laboratory values.

    Renal insufficiency
    In the 2014 Lancet Oncologypublication 2 criteria surrounding renal insufficiency were outlined. This included patients with either a creatinine above 2.0 mg/dL or a creatinine clearance (CrCl) below 40 mL/min, which may be a more useful measure of renal function.

    Anemia
    Patients who have hemoglobin levels below 10 g/dL, which is equivalent to a hematocrit of approximately 30% or 2 g/dL lower than the ULN(?), would meet the diagnostic criteria.

    Bone lesions
    patients with bone lesions, which may be as little as osteopenia, but also as much as osteolytic lesions and lesions at risk of fracture also meet the diagnostic criteria.

    In addition, under the new diagnostic criteria, patients meeting any one of the following biomarkers would also be considered to have MM requiring treatment: patients who have a plasma cell percentage in their bone marrow above 60%, an uninvolved to involved free light chain (FLC) ratio of 100 or more, or 2 or more focal lesions of at least 5 mm by magnetic resonance imaging.

    Last edited by Janis.Y.Chen; Wed 1st June '16 at 2:11pm.
    Clinical Pharmacy Specialist - Infectious Diseases

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