Fig. 1
Fig. 2
Diagnostic criteria for multiple myeloma (11)
| Criteria | Definition |
|---|---|
| Sixty % | 60 % plasma cell infiltration in bone marrow |
| Light chain | FLC κ/λ ratio > 100 |
| MRI | > 1 focal bone lesion |
| Calcium | Hypercalcemia > 2.75 mmol/l or > 0.25 mmol/l above upper limit of normal |
| Renal insufficiency | Creatinine > 173 μmol/l or creatinine clearence < 40ml/min |
| Anemia | Hb < 100 g/l or > 20g/l below lower limit of normal |
| Bone lesions | ≥ 1 osteolysis on skeletal radiography: X-ray, CT or PET/CT |
Interpretation of the determination FLC (1,2)
| Parameter | FLC κappa | FLC λambda | κ/λ ratio |
|---|---|---|---|
| Normal ratio | 3,3 – 19,4 mg/l | 5,5 – 26,3 mg/l | 0,26 – 1,65 |
| Monoclonal gammopathy | increased | normal/decreased | increased |
| Monoclonal gammopathy | normal/decreased | increased | decreased |
| Bi/oligoclonal diseases | increased | increased | varied* |
| Polyclonal diseases | increased | increased | normal |
| Renal injury | increased | increased | slightly increased |
| Reference values – nephrological patients** |
| ||
| Bone marrow suppression | decreased | decreased | normal |