CRAB criteria

The CRAB criteria are part of the diagnosis of multiple myeloma . They are defined as follows:

CRAB stands as an acronym for:

C : hyper C alcaemia , hypercalcemia with a serum calcium value of> 2.75 mmol / L or> 0.25 mmol / l is above the upper limit of normal.
R : R enal failure , renal failure with a serum creatinine > 2 mg / dl or creatinine clearance <40 ml / min.

A : A nemia , anemia with hemoglobin <10 g / dl or more than 2.0 g / dL below the lower limit of normal.

B : B one lesions , bone lesions with one or more osteolytic lesions.

Together with a biopsy confirmed value of at least 10% clonal plasma cells in the bone marrow of affected patients, at least one fulfilled CRAB criterion is also sufficient to diagnose symptomatic multiple myeloma. At the same time, this gives the indication to start therapy.

The International Myeloma Working Group updated and expanded the criteria in 2014 to include the so-called SLiM criteria :

S : S ixty percent bone marrow plasma cells , a more than 60% infiltration of plasma cells in the bone marrow .

Li : Involved: uninvolved serum free Li ght chain ratio ≥ 100 , increase of the light chain ratio from involved free light chain to uninvolved free light chain ≥ 100 at a concentration of the increased light chain of at least 100 mg / l.

M : > 1 focal lesions on M RI studies , in magnetic resonance imaging more than one focal bone lesion of at least 5 mm in size can be seen in the full-body image.

Here, too, a biopsy-confirmed value of at least 10% clonal plasma cells in the bone marrow of affected patients together with at least one of the SLiM criteria is sufficient for diagnosing symptomatic multiple myeloma. Furthermore, the indication to start therapy is also given here.

Web links

Individual evidence

^ SV Rajkumar et al .: International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma . In: Lancet . 15, No. 12, November 15, 2014, pp. E538-48. doi : 10.1016 / s1470-2045 (14) 70442-5 . PMID 25439696 .

[Rajkumar-1] SV Rajkumar et al .: International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma . In: Lancet . 15, No. 12, November 15, 2014, pp. E538-48. doi : 10.1016 / s1470-2045 (14) 70442-5 . PMID 25439696 .