IWWM-7 response criteria for Waldenström macroglobulinemia

Response category	Description
Complete response (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
Very good partial response (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
Partial response (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
Minor response (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 to the disease

IgM: immunoglobulin M.
* 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.

From: Owen RG, Kyle RA, Stone MJ, et al; VIth International Workshop on Waldenstrom macroglobulinaemia. Response assessment in Waldenstrom macroglobulinaemia: update from the VIth International Workshop. Br J Haematol 2013; 160:171. http://onlinelibrary.wiley.com/doi/10.1111/bjh.12102/abstract. Copyright © 2013 Blackwell Publishing Ltd. Reproduced with permission of John Wiley & Sons Inc. This image has been provided by or is owned by Wiley. Further permission is needed before it can be downloaded to PowerPoint, printed, shared or emailed. Please contact Wiley's permissions department on permissions@wiley.com or use the RightsLink service by clicking on the 'Request Permission' link accompanying this article on Wiley Online Library (http://onlinelibrary.wiley.com).

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