Table 2 Consensus-based uniform response... | American Society of Hematology

Table 2

Consensus-based uniform response criteria for WM developed by the IWWM, updated in the sixth IWWM

Response category	Description
CR	Absence of serum monoclonal IgM protein by immunofixation
	Normal serum IgM level
	Complete resolution of extramedullary disease, ie, lymphadenopathy and splenomegaly if present at baseline
	Morphologically normal bone marrow aspirate and trephine biopsy
VGPR	Monoclonal IgM protein is detectable
	≥90% reduction in serum IgM level from baseline*
	Complete resolution of extramedullary disease, ie, lymphadenopathy/splenomegaly if present at baseline
	No new signs or symptoms of active disease
PR	Monoclonal IgM protein is detectable
	≥50% but<90% reduction in serum IgM level from baseline*
	Reduction in extramedullary disease, ie, lymphadenopathy/splenomegaly if present at baseline
	No new signs or symptoms of active disease
MR	Monoclonal IgM protein is detectable
	≥25% but <50% reduction in serum IgM level from baseline*
	No new signs or symptoms of active disease
Stable disease	Monoclonal IgM protein is detectable
	<25% reduction and <25% increase in serum IgM level from baseline*
	No progression in extramedullary disease, ie, lymphadenopathy/splenomegaly
	No new signs or symptoms of active disease
Progressive disease	≥25% increase in serum IgM level*†from lowest nadir (requires confirmation) and/or progression in clinical features attributable the disease

Response category	Description
CR	Absence of serum monoclonal IgM protein by immunofixation
	Normal serum IgM level
	Complete resolution of extramedullary disease, ie, lymphadenopathy and splenomegaly if present at baseline
	Morphologically normal bone marrow aspirate and trephine biopsy
VGPR	Monoclonal IgM protein is detectable
	≥90% reduction in serum IgM level from baseline*
	Complete resolution of extramedullary disease, ie, lymphadenopathy/splenomegaly if present at baseline
	No new signs or symptoms of active disease
PR	Monoclonal IgM protein is detectable
	≥50% but<90% reduction in serum IgM level from baseline*
	Reduction in extramedullary disease, ie, lymphadenopathy/splenomegaly if present at baseline
	No new signs or symptoms of active disease
MR	Monoclonal IgM protein is detectable
	≥25% but <50% reduction in serum IgM level from baseline*
	No new signs or symptoms of active disease
Stable disease	Monoclonal IgM protein is detectable
	<25% reduction and <25% increase in serum IgM level from baseline*
	No progression in extramedullary disease, ie, lymphadenopathy/splenomegaly
	No new signs or symptoms of active disease
Progressive disease	≥25% increase in serum IgM level*†from lowest nadir (requires confirmation) and/or progression in clinical features attributable the disease

Published by Owen et al.¹³

Sequential changes in IgM levels may be determined either by M-protein quantitation by densitometry or total serum IgM quantitation by nephelometry.

An absolute increase of >5 g/L (0.5 g/dL) is required when the increase of IgM component is the only applicable criterion.