Table 1. Criteria for hematologic and... | American Society of Hematology

Table 1.

Criteria for hematologic and organ response

Hematologic response	Criteria
Complete response (CR)	Both criteria must be met: • Absence of amyloidogenic light chains (either free and/or as part of a complete immunoglobulin) defined by negative immunofixation electrophoresis of both serum and urine. • Either a FLC ratio within the reference range or the uninvolved FLC concentration is greater than involved FLC concentration with or without an abnormal FLC ratio
Very good partial response (VGPR)	dFLC <40 mg/L
Partial response (PR)	dFLC decrease >50%
No response (NR)	Less than a partial response
Organ response
Cardiac response	Decrease of NT-proBNP by >30% and 300 ng/L (if baseline NT-proBNP >650 ng/L)
Renal response	At least 30% decrease in proteinuria or drop below 0.5 g/24 h, in the absence of renal progression defined as a >25% decrease in eGFR
Hepatic response	50% decrease in abnormal alkaline phosphatase value or decrease in radiographic liver size by ≥2 cm

Hematologic response	Criteria
Complete response (CR)	Both criteria must be met: • Absence of amyloidogenic light chains (either free and/or as part of a complete immunoglobulin) defined by negative immunofixation electrophoresis of both serum and urine. • Either a FLC ratio within the reference range or the uninvolved FLC concentration is greater than involved FLC concentration with or without an abnormal FLC ratio
Very good partial response (VGPR)	dFLC <40 mg/L
Partial response (PR)	dFLC decrease >50%
No response (NR)	Less than a partial response
Organ response
Cardiac response	Decrease of NT-proBNP by >30% and 300 ng/L (if baseline NT-proBNP >650 ng/L)
Renal response	At least 30% decrease in proteinuria or drop below 0.5 g/24 h, in the absence of renal progression defined as a >25% decrease in eGFR
Hepatic response	50% decrease in abnormal alkaline phosphatase value or decrease in radiographic liver size by ≥2 cm

Hematologic, cardiac, and renal response criteria have been validated,^39,51 whereas hepatic response criteria have been obtained by consensus.⁵² A value adequate to measure hematologic response is deemed to be 50 mg/L. For patients with dFLC between 50 and 20 mg/L, hematologic response other than complete response (ungraded) is reached when dFLC falls below 10 mg/L.^53,54

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