cliot (version 1.0.0)

multiple_myeloma_response_criteria: IMWG Multiple Myeloma Response Criteria

Description

Evaluates the response to treatment in patients with Multiple Myeloma according to the International Myeloma Working Group (IMWG) uniform response criteria. Classification ranges from Progressive Disease (PD) to Stringent Complete Response (sCR) based on changes in M-protein (serum/urine), FLC levels, bone marrow plasma cells, and imaging findings relative to baseline or nadir.

Usage

multiple_myeloma_response_criteria(serum_m_baseline, serum_m_nadir, serum_m_current,
                                   urine_m_baseline, urine_m_nadir, urine_m_current,
                                   flc_diff_baseline, flc_diff_nadir, flc_diff_current,
                                   bone_marrow_pct, immunofixation_status, flc_ratio,
                                   plasmacytoma_status, bone_lesions_new_increased,
                                   hypercalcemia_present)

Value

A list containing:

Response_Category

The determined response status (sCR, CR, VGPR, PR, SD, or PD).

Inputs

Structured list of input values used for calculation.

Arguments

serum_m_baseline

Numeric. Baseline Serum M-protein (g/dL).

serum_m_nadir

Numeric. Lowest recorded Serum M-protein (g/dL). Used for PD assessment.

serum_m_current

Numeric. Current Serum M-protein (g/dL).

urine_m_baseline

Numeric. Baseline Urine M-protein (mg/24h).

urine_m_nadir

Numeric. Lowest recorded Urine M-protein (mg/24h).

urine_m_current

Numeric. Current Urine M-protein (mg/24h).

flc_diff_baseline

Numeric. Baseline difference between involved and uninvolved FLC (mg/dL).

flc_diff_nadir

Numeric. Lowest recorded FLC difference (mg/dL).

flc_diff_current

Numeric. Current FLC difference (mg/dL).

bone_marrow_pct

Numeric. Current percentage of bone marrow plasma cells.

immunofixation_status

String. Result of serum/urine immunofixation. Options: "positive", "negative".

flc_ratio

Numeric. Current Kappa/Lambda FLC ratio. (Normal range approx 0.26-1.65 used for sCR).

plasmacytoma_status

String. Status of soft tissue plasmacytomas. Options: "none", "stable", "decreased_50" (>=50% decrease), "disappeared", "increased", "new".

bone_lesions_new_increased

Numeric (0 or 1). Development of new or increased size of lytic bone lesions. (1 = Yes).

hypercalcemia_present

Numeric (0 or 1). Development of hypercalcemia (>11.5 mg/dL) attributable to plasma cell proliferative disorder. (1 = Yes).

References

Kumar S, Paiva B, Anderson KC, et al. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17(8):e328-e346. doi:10.1016/S1470-2045(16)30206-6

Examples

# Example 1: Partial Response
# Baseline M=4.0, Current M=1.5 (Reduc >50%), IFE Positive
multiple_myeloma_response_criteria(4.0, 1.0, 1.5, 0, 0, 0, 0, 0,
0, 8, "positive", 2.0, "none", 0, 0)

# Example 2: Progressive Disease
# Nadir M=1.0, Current M=2.0 (Increase >0.5g/dL and >25%)
multiple_myeloma_response_criteria(4.0, 1.0, 2.0, 0, 0, 0, 0, 0,
0, 10, "positive", 2.0, "none", 0, 0)