Hi, my name is Rafael Fonseca, I am a professor medicine at the Mayo Clinic in Arizona. I am frequently asked to define a complete response and a stringent complete response both in the setting of clinical trials as well as standard clinical practice. Complete response remains as it has always been, it is our patients who achieve a negative immunofixation on the serum and urine and who also have an appearance of a soft tissue plasmacytomas and achieve less than or equal to 5% plasma cells in the bone marrow. In the latest criteria, however, we introduce the objective of a stringent complete response, and this is one that takes into consideration now more sensitive methods for the detection of monoclonal plasma cells. Patients with a stringent complete response in addition to the criteria that is required to have a complete response are required to have a normal free light chain ratio in the serum and absence of clonal cells in the bone marrow determined by either immunofluorescence or immunohistochemistry.
Reviewed on January 17, 2017 for clinical relevance.