cliot (version 1.0.0)

multiple_myeloma_diagnosis: IMWG Diagnostic Criteria for Multiple Myeloma

Description

Evaluates patient data against the International Myeloma Working Group (IMWG) criteria to diagnose Active Multiple Myeloma, Smoldering Multiple Myeloma, or MGUS. Diagnosis of Active MM requires the presence of >=10% clonal bone marrow plasma cells (or biopsy-proven plasmacytoma) plus at least one myeloma-defining event (CRAB feature or SLiM biomarker).

Usage

multiple_myeloma_diagnosis(bmpc_percent, plasmacytoma, calcium_elevated,
                           renal_insufficiency, anemia, bone_lesions,
                           flc_ratio_gt_100, mri_focal_lesions_gt_1,
                           m_protein_g_dl = 0)

Value

A list containing:

Diagnosis

The resulting diagnosis (Active MM, Smoldering MM, or MGUS).

Criteria_Met

Summary of which major criteria categories (CRAB, SLiM) were satisfied.

Arguments

bmpc_percent

Numeric. Clonal bone marrow plasma cell percentage.

plasmacytoma

Numeric (0 or 1). Biopsy-proven bony or extramedullary plasmacytoma. (1 = Yes).

calcium_elevated

Numeric (0 or 1). Serum calcium > 1 mg/dL above upper limit of normal or > 11 mg/dL. (1 = Yes).

renal_insufficiency

Numeric (0 or 1). Renal insufficiency (Creatinine > 2 mg/dL or CrCl < 40 mL/min). (1 = Yes).

anemia

Numeric (0 or 1). Hemoglobin > 2 g/dL below lower limit of normal or < 10 g/dL. (1 = Yes).

bone_lesions

Numeric (0 or 1). One or more osteolytic bone lesions on skeletal radiography, CT, or PET-CT. (1 = Yes).

flc_ratio_gt_100

Numeric (0 or 1). Involved:Uninvolved serum free light chain ratio >= 100 (with involved FLC >= 100 mg/L). (1 = Yes).

mri_focal_lesions_gt_1

Numeric (0 or 1). >1 focal lesions on MRI (at least 5mm in size). (1 = Yes).

m_protein_g_dl

Numeric (Optional). Serum M-protein level in g/dL. Used to distinguish Smoldering MM from MGUS if BMPC is <10%.

References

Rajkumar SV, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-e548. doi:10.1016/S1470-2045(14)70442-5

Examples

# Example 1: Active MM (CRAB feature)
# 15% BMPC, Anemia present
multiple_myeloma_diagnosis(15, 0, 0, 0, 1, 0, 0, 0)

# Example 2: Active MM (SLiM feature)
# 20% BMPC, No CRAB, but FLC Ratio > 100
multiple_myeloma_diagnosis(20, 0, 0, 0, 0, 0, 1, 0)

# Example 3: Smoldering MM
# 20% BMPC, No CRAB, No SLiM
multiple_myeloma_diagnosis(20, 0, 0, 0, 0, 0, 0, 0)