Monitoring Monoclonal Gammopathies

Methods for Monitoring Monoclonal Gammopathies: 2005 IMWG

November 2009

The International Myeloma Working Group has defined responses. A 25% to 49% reduction is a minimal response, and a 50% reduction in the serum M-spike is a partial response. The IgG kappa patient we saw on a previous slide would need the M-spike to go from 3.8 g/dL to <1.9 g/dL to be considered a partial responder. For a complete response, we would, of course, need the complete absence of a detectable serum monoclonal protein. These same guidelines require a 90% reduction in the urine M-spike for a partial response. And, the patient with the lambda light chain myeloma would need the urine M-spike to go from 2.6 g/24 hour to <0.3 g/24 hour to be considered a partial response.

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2005 IMWG

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Jump to section:

• Introduction
• Slide Images
• International Myeloma Working Group: Disease Monitoring
• Serum Protein Electrophoresis and Immunofixation Electrophoresis
• Serum and Urine Protein Electrophoresis and Immunofixation Electrophoresis
• Methods for Monitoring Monoclonal Gammopathies: 2005 IMWG
• Methods for Monitoring Monoclonal Gammopathies
• Small IgG kappa M-spike
• Large IgG kappa M-spike
• Relationship of Serum Agarose Electrophoresis M-spike and Ig Quantitation¹
• Disease Monitoring
• Monoclonal Gammopathies: Primary Systemic Amyloidosis
• Free Light Chain: Antibody Specificity
• FLC κ/λ Ratio: Disease Sensitivity²
• Methods for Monitoring Monoclonal Gammopathies
• International Myeloma Working Group: 2009 Guidelines for Disease Monitoring³
• Response Criteria for FLC^4,5
• Receiver Operator Curve (ROC): % FLC Reduction vs. Overall Hematologic Response⁶
• International Myeloma Working Group: 2009 Guidelines for Disease Monitoring
• References
• Questions?