Thank you Thank you Donna Andrew

The current diagnostic criteria for symptomatic multiple myeloma are as follows [139] :

Clonal bone marrow plasma cells ≥10% or bony or extramedullary plasmacytoma (confirmed by biopsy)

One or more myeloma-defining events.

Myeloma-defining events include the following  [139] :

Hypercalcemia: Serum calcium level > 1 mg/dL (> 0.25 mmol/L) higher than the upper limit of normal or > 2.75 mmol/L (> 11 mg/dL)

Abnormal kidney function: Serum creatinine > 2 mg/dL (> 177 μmol/L) or creatinine clearance < 40 mL/min

Anemia: Hemoglobin < 10 g/dL, or  > 2 g/dL below the lower limit of normal

Bone lesions: One or more osteolytic lesions on skeletal radiography, CT, or PET-CT

Biomarkers of malignancy: Clonal bone marrow plasma cells ≥60% and/or  involved/uninvolved serum FLC ratio ≥100 (involved kappa) or < 0.01 (involved lambda) and/or one or more focal ≥5 mm lesions on MRI scans