Version July 2025
| System | Response |
| Hematologic[1,2] | CR: Negative serum and urine immunofixation plus either normalization of the FLC ratio or uninvolved FLC concentration greater than involved FLC concentration with or without an abnormal FLC ratio VGPR: Reduction in the dFLC to <40 mg/L* PR: A >50% reduction in the dFLC* No response: Less than a PR |
| Cardiac[3] | CR: Nadir NT-proBNP ≤350 pg/mL (≤41.39 pmol/L) or BNP ≤80 pg/mL (≤9.46 pmol/L) VGPR: >60% reduction in NT-proBNP/BNP from baseline level, not meeting cardiac CR criteria PR: 31 to 60% reduction in NT-proBNP from baseline level not meeting CR No response: ≤30% reduction in NT-proBNP from baseline level |
| Kidney[4] | CR: Nadir proteinuria ≤200 mg/24 h VGPR: >60% reduction in proteinuria from baseline level, not meeting renal CR criteria PR: 31 to 50% reduction in proteinuria from baseline level, not meeting renal CR criteria No response: ≤30% reduction in proteinuria from baseline level |
| Liver[4] | CR: Nadir alkaline phosphatase ≤2 times lower limit of normal VGPR: >60% reduction in alkaline phosphatase from baseline level, not meeting hepatic CR criteria PR: 31 to 50% reduction in alkaline phosphatase from baseline level, not meeting hepatic CR criteria No response: <50% decrease in serum alkaline phosphatase from baseline value |
BNP: B-type natriuretic peptide; CR: complete response; dFLC: difference between involved FLC and uninvolved FLC; FLC: free light chain; NT-proBNP: N-terminal pro-B-type natriuretic peptide; PR: partial response; VGPR: very good partial response.
* The dFLC values used in these response criteria do not apply to the approximately 20% of patients with a pretreatment dFLC <50 mg/L. If the pretreatment dFLC is between 20 and 50 mg/L, a dFLC <10 mg/L can be used to define a dFLC-based PR[5,6].
