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Diagnostic Criteria for Multiple Myeloma

Presence of an M-componenta in serum and/or urine plus clonal plasma cells in the bone marrow and/or a documented clonal plasmacytoma

PLUS one or more of the following:b

  • Calcium elevation (>11.5 mg/dl) [>2.65 mmol/l]

  • Renal insufficiency (creatinine >2 mg/dl) [177 mmol/l or more]

  • Anemia (hemoglobin <10 g/dl or 2 g/dl <normal) (hemoglobin <12.5 mmol/lc or 1.25 mmol/l <normal)

  • Bone disease (lytic lesions or osteopenia)

aIn patients with no detectable M-component, an abnormal serum FLC ratio on the serum FLC assay can substitute and satisfy this criterion. For patients, with no serum or urine M-component and normal serum  FLC ratio, the baseline bone marrow must have >10% clonal plasma  cells; these patients are referred to as having ‘non-secretory myeloma’. Patients with biopsy-proven amyloidosis and/or systemic light chain deposition disease (LCDD) should be classified as ‘myeloma with documented amyloidosis’ or ‘myeloma with documented LCDD,’ respectively if they have >30% plasma cells and/or myeloma-related bone disease.

bMust be attributable to the underlying plasma cell disorder.

cNote: Hemoglobin of 10 g/dl is 12.5 mmol/l [or 100 g/l].


Related Criteria

Classification of Neutropenia

Classification of Neutrophilia

Serum Levels That Differentiate Anemia of Chronic Disease from Iron-Deficiency Anemia

Diagnostic Criteria for Disseminated Intravascular Coagulation (DIC)

Clinical Conditions Associated with Disseminated Intravascular Coagulation (DIC)

Diagnostic Criteria for Systemic Mastocytosis (SM)

WHO Classification of Mastocytosis

FAB Classification of Myelodysplastic Syndromes (MDS)

Diagnostic Criteria for Heparin-Induced Thrombocytopenia (HIT)



  1. Durie BG, Harousseau JL, Miguel JS, Bladé J, Barlogie B, Anderson K, Gertz M, Dimopoulos M, Westin J, Sonneveld P, Ludwig H, Gahrton G, Beksac M, Crowley J, Belch A, Boccadaro M, Cavo M, Turesson I, Joshua D, Vesole D, Kyle R, Alexanian R, Tricot G, Attal M, Merlini G, Powles R, Richardson P, Shimizu K, Tosi P, Morgan G, Rajkumar SV; International Myeloma Working Group . International uniform response criteria for multiple myeloma. Leukemia. 2006 Sep;20(9):1467-73. [Medline]

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Created: June 17, 2007
Last Modified: 10/23/2010

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