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CLINICAL SYMPTOMS AND LABORATORY ABNORMALITIES

Patients must present with ≥ 2 of the symptoms listed in table 2, of which 1 must be a laboratory abnormality.1

Table 2: Symptoms of iMCD

LABORATORY
ABNORMALITIES* 		CLINICAL
SYMPTOMS
Elevated CRP (>10 mg/L) or ESR (>15 mm/h)‡ Constitutional symptoms (night sweats, fever › 38˚C, weight loss or fatigue†)
Anaemia (haemoglobin <12.5 g/dL in males or <11.5 g/dL in females) Fluid accumulation (oedema, anasarca, ascites or pleural effusion)
Thrombocytopaenia (platelet count <150 x 103 cells/µL) or thrombocytosis (platelet count >400 x 103 cells/µL) Eruptive cherry hemangiomatosis or violaceous papules
Hypoalbulinaemia (albumin <35 g/dL) Enlarged spleen and/or liver
Renal dysfunction (eGFR <60 mL/min/1.73 m2) or proteinuria (total protein 150 mg/24 h or 10 mg/100 mL urine) Lymphocytic interstitial pneumonitis
Polyclonal hypergammaglobulinaemia (total Ɣ globulin or IgG >1700 mg/dL) -

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*  Laboratory thresholds are provided as guidance, local thresholds may be used do the variation between laboratories.
†  ≥2 CTCAE lymphoma score for B-symptoms.
‡  CRP evaluation is preferred and tracking is encouraged; ESR is acceptable if CRP is not available.

CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; IgG, immunoglobulin G.

EUSA Sylvant © 2021 EUSA Pharma      Date of prep: November 2021    GL-SIL-2100101

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