Treatment of multiple myeloma has substantially changed over the past decade with the introduction of several classes of new effective drugs that have greatly improved the rates and depth of response. Response criteria in multiple myeloma were developed to use serum and urine assessment of monoclonal proteins and bone marrow assessment (which is relatively insensitive). Given the high rates of complete response seen in patients with multiple myeloma with new treatment approaches, new response categories need to be defined that can identify responses that are deeper than those conventionally defined as complete response. Recent attempts have focused on the identification of residual tumour cells in the bone marrow using flow cytometry or gene sequencing. Furthermore, sensitive imaging techniques can be used to detect the presence of residual disease outside of the bone marrow. Combining these new methods, the International Myeloma Working Group has defined new response categories of minimal residual disease negativity, with or without imaging-based absence of extramedullary disease, to allow uniform reporting within and outside clinical trials. In this Review, we clarify several aspects of disease response assessment, along with endpoints for clinical trials, and highlight future directions for disease response assessments.

https://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(16)30206-6.pdf

International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma

EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis

Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis

EASL clinical practice guidelines on the management of ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome in cirrhosis.

https://www.naspghan.org/files/documents/pdfs/training/curriculum-resources/biliary-disease/aasld-guidelines/EASL_Cholestatic_Dz.pdf

EASL Clinical Practice Guidelines: management of cholestatic liver diseases

Gastric mucosal vascular ectasias causing bleeding in cirrhosis: A distinct entity associated with hypergastrinemia and low serum levels of pepsinogen I

Comparison of rifampicin with phenobarbitone for treatment of pruritus in biliary cirrhosis

https://www.gastrojournal.org/article/0016-5085(92)90335-V/pdf

Effects of long-term rifampicin administration in primary biliary cirrhosis

VCAM-1 and ICAM-1 mediate leukocyte-endothelial cell adhesion in rat experimental colitis.

https://www.gastrojournal.org/article/0016-5085(82)90129-9/pdf

Montserrat Elena

Papers

Gastric mucosal vascular ectasias causing bleeding in cirrhosis: A distinct entity associated with hypergastrinemia and low serum levels of pepsinogen I

Comparison of rifampicin with phenobarbitone for treatment of pruritus in biliary cirrhosis

Effects of long-term rifampicin administration in primary biliary cirrhosis

VCAM-1 and ICAM-1 mediate leukocyte-endothelial cell adhesion in rat experimental colitis.

Aminoglycoside nephrotoxicity in cirrhosis: Value of urinary β2-microglobulin to discriminate functional renal failure from acute tubular damage