Critères de CRAB Anomalies des dritères de CRAB au diagnostic du myélome multiple : e 11m 13 % 72% 80 % 80 u norm so attfibu ables Vt.ques pathologiques . Time to first anti-myeloma treatment 8. Time to symptomatic skeletal-related event 7. P rogression from SMM to symptomatic multiple myeloma occurs in 10% patients annually for the first 5 years and 3% annually every next 3 years; progression from MGUS to symptomatic multiple myeloma occurs in 1% patients ⦠In 2014, the revised International Staging System (R-ISS) for myeloma was introduced, with updates including specific biomarkers in addition to the established markers of end-organ damage. small bowel The middle part of the gastrointestinal tract, which takes food from the stomach and absorbs nutrients. Patients with relapsed disease requiring therapy (development of new SLiM-CRAB criteria or significant paraprotein relapse) or refractory MM: Treatment should not be postponed; Therapeutic decisions should be made on a case-by-case basis, considering disease stage, risk, cytogenetics/FISH, age, comorbidities ; Consider G-CSF support to minimise risk of neutropaenia; Medium Priority. CRAB is the acronym for the most common symptoms of multiple myeloma: C = Calcium (elevated) - hypercalcemia: Myeloma attacks bone, and as bone is broken down, it causes high calcium levels in the blood. For D-VTd vs VTd pts in the slim-only group, these ⦠So, we have three more criteria that are now referred to as myeloma- defining events that would signify the need for treatment of the myeloma. MRI protocols limited to the spine or to spine plus pelvis lead to substantial underdiagnoses of patients who actually have >1 FL in wb-MRI at baseline and during follow-up, which influences staging and treatment decisions according to the current SLiM-CRAB criteria. Time to first anti-myeloma treatment 8. The âSâ stands for 60%: patients with â¥60% clonal plasma cells in the bone marrow are likely to experience disease progression and should thus be classified as having symptomatic MM. A revised risk stratification based on ⦠⦠... 81 were included in the slim-only subgroup (36 D-VTd; 45 VTd) and 1004 were included in the CRAB subgroup. R = Renal failure: The most common cause of kidney ⦠Incidence of bone lesions as MM defining events 5. Dr. Kumar emphasized that smoldering myeloma should not be seen as a biological entity but rather a mixture of monoclonal gammopathy of undetermined significance (MGUS) and early MM. Subsequently, patients are stratified as low-risk (absence of any of these factors), intermediate-risk (one factor present) or high-risk (two or more factors present). Time to symptomatic skeletal-related event 7. (SLiM-CRAB (S = sixty, Li = light chains, M = MRI, C = calcium [elevated], R = renal failure, A = anemia, B = bone lesions). In slim-only vs CRAB pts, 22% vs 54% had an ECOG score of â¥1, 4% vs 16% had ISS Stage III disease, and 11% vs 16% had high-risk cytogenetics. Percentage of âSLiMâ- part of âSLiM CRABâ criteria fulfilling patients at inclusion progressing to CRAB-positive MM within three years 4. We present a subgroup analysis of CASSIOPEIA based on baseline slimCRAB criteria. Key exclusion criteria included the presence of at least one SLiM-CRAB myeloma-defining event, as defined in the 2014 International Myeloma Working Group (IMWG) criteria ⦠According to the current SLiM-CRAB-criteria, asymptomatic multiple myeloma patients who show >1 focal lesion in MRI are now upstaged to multiple myeloma with treatment indication. The SLiM CRAB criteria identifies patients who should be treated for myeloma. CRAB features (and should therefore be considered for therapy), is needed.34 Rationale for updating of diagnostic criteria The present disease deï¬ nitions of smouldering multiple myeloma and multiple myeloma were reported by the International Myeloma Working Group (IMWG) in 2003.10 With minor clariï¬ cations,11 these criteria have In 2014, the IMWG updated their criteria further to include biomarkers of malignancy. CRAB and SLiM criteria and can be distinguished through the percentage of bone marrow plasma cell infiltration (<10% for MGUS, between 10 % and 59% for SMM) [3;4]. 1 The acronym CRAB is a mnemonic for the end-organ damage attributable to the underlying plasma cell proliferative disease. 2014 âIMWG. Incidence of bone lesions as MM defining events 5. Key inclusion criteria. 2 In addition to CRAB, infection is also a clinically significant symptom. Patients with a sole biochemical relapse may be treated in the event of a short doubling time of the serum M-protein or a significant and continuous increase of M-protein or serum free light ⦠The most critical criteria in the diagnosis of symptomatic multiple myeloma is the evidence of multiple myelomaârelated organ damage. The challenge is to distinguish these two groups of patients. Simple Summary: According to the current SLiM-CRAB-criteria, asymptomatic multiple myeloma patients who show >1 focal lesion in MRI are now upstaged to multiple myeloma with treatment indication. While the anatomic coverage of MRI protocols di ers from spine over spine plus pelvis to whole-body between di erent institutions, the cuto for the number of focal lesions which is currently ⦠Introduction de critères additionnels aux critères CRAB Conséquences pour : Risque de progression Recommandations de suivi SMM : groupe hétérogène Patients proches MGUS Patients proches MM. CRAB-like abnormalities are common with numerous diseases, and these abnormalities must be felt to be directly attributable to the related plasma cell disorder and every attempt made to rule out other underlying causes of anemia, kidney failure, etc. Often combined with the CRAB criteria to form the SLiM-CRAB criteria. Inclusion criteria: - Participants who are diagnosed within 5 years with SMM (per International Myeloma Working Group [IMWG] criteria), defined as serum M-protein =30 g/L or urinary M-protein =500 mg per 24 hour or both, and/or clonal bone marrow plasma cells (BMPCs) 10% to . Percentage of âSLiMâ- part of âSLiM CRABâ criteria fulfilling patients at inclusion progressing to CRAB-positive MM within three years 4. The criteria to which the doctors are referring is the SLiM CRAB criteria, which expands the former CRAB criteria. The Mayo Clinic revised risk stratification for SMM is based on the 20/20/20 criteria; BMPC >20%, M spike >20g/L and FLC ratio >20.