Criteria For Response And Progression

Serum and urine M-protein levels should be determined by electrophoresis rather than by quantitative immunoglobulin measurement. Exceptions are made in cases in which the M-protein value may be unreliable. In these cases, quantitative immunoglobulins should be used. To assess response and progression, however, serum protein electrophoresis (SPEP) values should be compared only to SPEP values and quantitative immunoglobulin values only to quantitative immunoglobulin values.

The international uniform response criteria11a are the standard criteria for clinical trials and have been adopted recently by cooperative groups such as ECOG. These criteria partially take into account hemoglobin, calcium, bone changes, and bone marrow plasmacyto-sis for assessment of response, but rely heavily on measurement of serum and urine M protein.

For clinical trial purposes certain arbitrary levels of serum and urine M-protein values are considered

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