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Achieving Complete Response in Multiple Myeloma: Do We Need to Change the Definition?

Multiple myeloma is a B cell neoplasm with monoclonal plasma cell expansion. The incidence varies between different countries from one per 100,000 to four per 100,000, probably due to under-diagnosis in developing countries. The therapeutic goal for multiple myeloma is prolonged progression free survival and overall survival. In recent years, it has been possible to detect smaller amounts of residual tumors through diagnostic and monitoring tools, such as IgH rearrangement qRT-PCR, multiparameter flow cytometry, microarray studies for methylation and imaging studies (e.g., positron emission tomography). A few studies have also proved the correlation between achieving molecular remission after treatment and progression free and overall survival. Therefore, the European Group for Blood and Marrow Transplant (EBMT) and International Myeloma Working Group (IMWG) uniform criteria seem to be inadequate to evaluate treatment response. Further studies on more sensitive tools are necessary for more accurate disease status evaluation.