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How is Active Multiple Myeloma Defined?
Posted: Jan 24, 2020
How is Active Multiple Myeloma Defined? image

How is active myeloma defined?


In the past, multiple myeloma was defined by four important "CRAB" features: Calcium, Renal, Anemia, and Bone Lesions. Each of these helps determine if you have myeloma in addition to a higher-than-normal monoclonal protein.  

Calcium: Calcium levels that are 1 mg/dl above normal levels or over 11 mg/dl

Renal Issues: Creatinine levels over 2 mg/dl

Anemia: If the hemoglobin number is more 2 grams/dl below normal or total hemoglobin less than 10 g/dl

Bone Lesions: More than one lesions detected by x-ray, CT or PET scan

Myeloma Defining Events

In time, myeloma experts decided that the CRAB criteria were not quite enough to define active disease, so they added three more "myeloma defining events." 

  • 60% clonal plasma cells in the bone marrow (normal is 1%)
  • Kappa/Lambda light chain ratio over 100 mg/l and a kappa or lambda light chain over 100 mg/l
  • More than one focal lesion on an MRI larger than 5 mm or more

Muzaffar Qazilbash, MD of MD Anderson Cancer Center joins HealthTree University to share how myeloma doctors define active disease. 

About HealthTree University

HealthTree University, provided by the Myeloma Crowd, offers a comprehensive online multiple myeloma curriculum with classes, lessons and quizzes. Learn for free at Topics covered include: myeloma basics, testing and blood markers, stem cell transplant, financial resources, immunotherapies, myeloma genetics and much more. We've partnered with over 60 myeloma experts to help you learn quickly. Improve the way you navigate your disease and obtain better outcomes with HealthTree University.

The author Jennifer Ahlstrom

about the author
Jennifer Ahlstrom

Myeloma survivor, patient advocate, wife, mom of 6. Believer that patients can help accelerate a cure by weighing in and participating in clinical research. Founder of HealthTree Foundation (formerly Myeloma Crowd). 

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