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IMWG myeloma response

IMWG response

Apply Kumar 2016 International Myeloma Working Group consensus criteria for treatment response in multiple myeloma on the measurable serum and urine M-protein pathway, returning sCR, CR, VGPR, PR, MR, SD, or PD from caller-assigned flags.

LIVE $0.005 USDC GET /api/calc/imwg_response

Markdown: /docs/imwg-response.md · Canonical: https://magentlab.com/docs/imwg-response

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Apply Kumar 2016 International Myeloma Working Group consensus criteria for treatment response in multiple myeloma on the measurable serum and urine M-protein pathway, returning sCR, CR, VGPR, PR, MR, SD, or PD from caller-assigned flags.

When to use

When an agent already has caller-assigned IMWG 2016 response flags for a patient with measurable serum and urine M-protein and needs the published first-match category. magent does not assay M-protein or free light chains, does not read marrow, and does not compute PD from serial values.

When not to use

• Not a medical device.
• Not a diagnosis. Response category is not a myeloma diagnosis or a treatment recommendation.
• Not the Rajkumar 2014 IMWG definition of multiple myeloma requiring therapy (imwg-myeloma).
• Measurable serum and urine M-protein pathway only. FLC-only and nonsecretory alternate PR pathways are not scored.
• Flow or NGS MRD-negativity categories are not scored.
• magent does not assay M-protein, free light chains, or immunofixation, and does not read marrow or immunohistochemistry. All flags are caller-assigned.
• imwg_pd is progressive disease as assigned by the caller using IMWG PD rules. magent does not compute PD from serial M-protein, FLC, or imaging values.
• bmpc_lt_5 is strictly fewer than 5% plasma cells in bone marrow aspirates (Kumar 2016 CR), not ≤5%.

Formula

Kumar 2016 IMWG measurable serum+urine M-protein response, first-match: PD if imwg_pd; else sCR iff CR_bits and flc_ratio_normal and no_clonal_cells_ihc; else CR iff CR_bits; else VGPR iff electrophoresis_negative or (serum_m_reduction_ge_90 and urine_m_lt_100); else PR iff serum_m_reduction_ge_50 and urine_m_pr; else MR iff serum_m_reduction_25_to_49 and urine_m_reduction_50_to_89; else SD. CR_bits = ife_serum_negative and ife_urine_negative and plasmacytomas_absent and bmpc_lt_5 (strictly <5% marrow plasma cells). Not FLC-only or nonsecretory. Not MRD. Not a diagnosis

Citation

Title

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

Authors

Kumar S, Paiva B, Anderson KC, Durie B, Landgren O, Moreau P, Munshi N, Lonial S, Bladé J, Mateos MV, Dimopoulos M, Kastritis E, Boccadoro M, Orlowski R, Zamagni E, Palumbo A, San Miguel J, Avet-Loiseau H, Goldschmidt H, van de Donk NWCJ, et al.

Source

Lancet Oncol. 2016;17(8):e328-e346

DOI

10.1016/S1470-2045(16)30206-6

Worked example

Also searched as

• IMWG response criteria
• Kumar 2016 myeloma response
• stringent complete response myeloma
• myeloma VGPR and PR
• International Myeloma Working Group response
• sCR CR VGPR PR
• IMWG M-protein response
• myeloma treatment response assessment

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/imwg_response?imwg_pd=false&ife_serum_negative=true&ife_urine_negative=true&plasmacytomas_absent=true&bmpc_lt_5=true&flc_ratio_normal=true&no_clonal_cells_ihc=true&electrophoresis_negative=false&serum_m_reduction_ge_90=false&urine_m_lt_100=false&serum_m_reduction_ge_50=false&urine_m_pr=false&serum_m_reduction_25_to_49=false&urine_m_reduction_50_to_89=false

Full URL: https://api.magentlab.com/api/calc/imwg_response?imwg_pd=false&ife_serum_negative=true&ife_urine_negative=true&plasmacytomas_absent=true&bmpc_lt_5=true&flc_ratio_normal=true&no_clonal_cells_ihc=true&electrophoresis_negative=false&serum_m_reduction_ge_90=false&urine_m_lt_100=false&serum_m_reduction_ge_50=false&urine_m_pr=false&serum_m_reduction_25_to_49=false&urine_m_reduction_50_to_89=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/imwg_response?imwg_pd=false&ife_serum_negative=true&ife_urine_negative=true&plasmacytomas_absent=true&bmpc_lt_5=true&flc_ratio_normal=true&no_clonal_cells_ihc=true&electrophoresis_negative=false&serum_m_reduction_ge_90=false&urine_m_lt_100=false&serum_m_reduction_ge_50=false&urine_m_pr=false&serum_m_reduction_25_to_49=false&urine_m_reduction_50_to_89=false"

Parameters

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/imwg_response Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

• 1 to 25 items. Each item uses the same keys as the GET query parameters.
• POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
• The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
• HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
• Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
• x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "bmpc_lt_5": "true",
      "electrophoresis_negative": "false",
      "flc_ratio_normal": "true",
      "ife_serum_negative": "true",
      "ife_urine_negative": "true",
      "imwg_pd": "false",
      "no_clonal_cells_ihc": "true",
      "plasmacytomas_absent": "true",
      "serum_m_reduction_25_to_49": "false",
      "serum_m_reduction_ge_50": "false",
      "serum_m_reduction_ge_90": "false",
      "urine_m_lt_100": "false",
      "urine_m_pr": "false",
      "urine_m_reduction_50_to_89": "false"
    },
    {
      "bmpc_lt_5": "true",
      "electrophoresis_negative": "false",
      "flc_ratio_normal": "true",
      "ife_serum_negative": "true",
      "ife_urine_negative": "true",
      "imwg_pd": "false",
      "no_clonal_cells_ihc": "true",
      "plasmacytomas_absent": "true",
      "serum_m_reduction_25_to_49": "false",
      "serum_m_reduction_ge_50": "false",
      "serum_m_reduction_ge_90": "false",
      "urine_m_lt_100": "false",
      "urine_m_pr": "false",
      "urine_m_reduction_50_to_89": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/imwg_response",
  "items": [
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Kumar S, Paiva B, Anderson KC, Durie B, Landgren O, Moreau P, Munshi N, Lonial S, Bladé J, Mateos MV, Dimopoulos M, Kastritis E, Boccadoro M, Orlowski R, Zamagni E, Palumbo A, San Miguel J, Avet-Loiseau H, Goldschmidt H, van de Donk NWCJ, et al.",
        "doi": "10.1016/S1470-2045(16)30206-6",
        "id": "kumar-2016",
        "pmid": "27511158",
        "source": "Lancet Oncol. 2016;17(8):e328-e346",
        "title": "International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma"
      },
      "formula": "imwg_response",
      "formula_expression": "Kumar 2016 IMWG measurable serum+urine M-protein response, first-match: PD if imwg_pd; else sCR iff CR_bits and flc_ratio_normal and no_clonal_cells_ihc; else CR iff CR_bits; else VGPR iff electrophoresis_negative or (serum_m_reduction_ge_90 and urine_m_lt_100); else PR iff serum_m_reduction_ge_50 and urine_m_pr; else MR iff serum_m_reduction_25_to_49 and urine_m_reduction_50_to_89; else SD. CR_bits = ife_serum_negative and ife_urine_negative and plasmacytomas_absent and bmpc_lt_5 (strictly <5% marrow plasma cells). Not FLC-only or nonsecretory. Not MRD. Not a diagnosis",
      "criteria": [
        {
          "factor": "imwg_pd",
          "met": false
        },
        {
          "factor": "ife_serum_negative",
          "met": true
        },
        {
          "factor": "ife_urine_negative",
          "met": true
        },
        {
          "factor": "plasmacytomas_absent",
          "met": true
        },
        {
          "factor": "bmpc_lt_5",
          "met": true
        },
        {
          "factor": "cr_bits",
          "met": true
        },
        {
          "factor": "flc_ratio_normal",
          "met": true
        },
        {
          "factor": "no_clonal_cells_ihc",
          "met": true
        },
        {
          "factor": "electrophoresis_negative",
          "met": false
        },
        {
          "factor": "serum_m_reduction_ge_90",
          "met": false
        },
        {
          "factor": "urine_m_lt_100",
          "met": false
        },
        {
          "factor": "serum_m_reduction_ge_50",
          "met": false
        },
        {
          "factor": "urine_m_pr",
          "met": false
        },
        {
          "factor": "serum_m_reduction_25_to_49",
          "met": false
        },
        {
          "factor": "urine_m_reduction_50_to_89",
          "met": false
        }
      ],
      "cr_bits": true,
      "imwg_response": "sCR"
    },
    {
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Kumar S, Paiva B, Anderson KC, Durie B, Landgren O, Moreau P, Munshi N, Lonial S, Bladé J, Mateos MV, Dimopoulos M, Kastritis E, Boccadoro M, Orlowski R, Zamagni E, Palumbo A, San Miguel J, Avet-Loiseau H, Goldschmidt H, van de Donk NWCJ, et al.",
        "doi": "10.1016/S1470-2045(16)30206-6",
        "id": "kumar-2016",
        "pmid": "27511158",
        "source": "Lancet Oncol. 2016;17(8):e328-e346",
        "title": "International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma"
      },
      "formula": "imwg_response",
      "formula_expression": "Kumar 2016 IMWG measurable serum+urine M-protein response, first-match: PD if imwg_pd; else sCR iff CR_bits and flc_ratio_normal and no_clonal_cells_ihc; else CR iff CR_bits; else VGPR iff electrophoresis_negative or (serum_m_reduction_ge_90 and urine_m_lt_100); else PR iff serum_m_reduction_ge_50 and urine_m_pr; else MR iff serum_m_reduction_25_to_49 and urine_m_reduction_50_to_89; else SD. CR_bits = ife_serum_negative and ife_urine_negative and plasmacytomas_absent and bmpc_lt_5 (strictly <5% marrow plasma cells). Not FLC-only or nonsecretory. Not MRD. Not a diagnosis",
      "criteria": [
        {
          "factor": "imwg_pd",
          "met": false
        },
        {
          "factor": "ife_serum_negative",
          "met": true
        },
        {
          "factor": "ife_urine_negative",
          "met": true
        },
        {
          "factor": "plasmacytomas_absent",
          "met": true
        },
        {
          "factor": "bmpc_lt_5",
          "met": true
        },
        {
          "factor": "cr_bits",
          "met": true
        },
        {
          "factor": "flc_ratio_normal",
          "met": true
        },
        {
          "factor": "no_clonal_cells_ihc",
          "met": true
        },
        {
          "factor": "electrophoresis_negative",
          "met": false
        },
        {
          "factor": "serum_m_reduction_ge_90",
          "met": false
        },
        {
          "factor": "urine_m_lt_100",
          "met": false
        },
        {
          "factor": "serum_m_reduction_ge_50",
          "met": false
        },
        {
          "factor": "urine_m_pr",
          "met": false
        },
        {
          "factor": "serum_m_reduction_25_to_49",
          "met": false
        },
        {
          "factor": "urine_m_reduction_50_to_89",
          "met": false
        }
      ],
      "cr_bits": true,
      "imwg_response": "sCR"
    }
  ]
}

Response

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Kumar S, Paiva B, Anderson KC, Durie B, Landgren O, Moreau P, Munshi N, Lonial S, Bladé J, Mateos MV, Dimopoulos M, Kastritis E, Boccadoro M, Orlowski R, Zamagni E, Palumbo A, San Miguel J, Avet-Loiseau H, Goldschmidt H, van de Donk NWCJ, et al.",
    "doi": "10.1016/S1470-2045(16)30206-6",
    "id": "kumar-2016",
    "pmid": "27511158",
    "source": "Lancet Oncol. 2016;17(8):e328-e346",
    "title": "International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma"
  },
  "formula": "imwg_response",
  "formula_expression": "Kumar 2016 IMWG measurable serum+urine M-protein response, first-match: PD if imwg_pd; else sCR iff CR_bits and flc_ratio_normal and no_clonal_cells_ihc; else CR iff CR_bits; else VGPR iff electrophoresis_negative or (serum_m_reduction_ge_90 and urine_m_lt_100); else PR iff serum_m_reduction_ge_50 and urine_m_pr; else MR iff serum_m_reduction_25_to_49 and urine_m_reduction_50_to_89; else SD. CR_bits = ife_serum_negative and ife_urine_negative and plasmacytomas_absent and bmpc_lt_5 (strictly <5% marrow plasma cells). Not FLC-only or nonsecretory. Not MRD. Not a diagnosis",
  "criteria": [
    {
      "factor": "imwg_pd",
      "met": false
    },
    {
      "factor": "ife_serum_negative",
      "met": true
    },
    {
      "factor": "ife_urine_negative",
      "met": true
    },
    {
      "factor": "plasmacytomas_absent",
      "met": true
    },
    {
      "factor": "bmpc_lt_5",
      "met": true
    },
    {
      "factor": "cr_bits",
      "met": true
    },
    {
      "factor": "flc_ratio_normal",
      "met": true
    },
    {
      "factor": "no_clonal_cells_ihc",
      "met": true
    },
    {
      "factor": "electrophoresis_negative",
      "met": false
    },
    {
      "factor": "serum_m_reduction_ge_90",
      "met": false
    },
    {
      "factor": "urine_m_lt_100",
      "met": false
    },
    {
      "factor": "serum_m_reduction_ge_50",
      "met": false
    },
    {
      "factor": "urine_m_pr",
      "met": false
    },
    {
      "factor": "serum_m_reduction_25_to_49",
      "met": false
    },
    {
      "factor": "urine_m_reduction_50_to_89",
      "met": false
    }
  ],
  "cr_bits": true,
  "imwg_response": "sCR"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

Related tools

• IMWG myeloma criteria — Apply the Rajkumar 2014 International Myeloma Working Group updated criteria for multiple myeloma requiring therapy: clonal bone marrow plasma cells ≥10% or biopsy-proven plasmacytoma plus at least one myeloma-defining event (CRAB or SLiM).
• Myeloma ISS — Apply the Greipp 2005 International Staging System for multiple myeloma from serum beta-2 microglobulin and albumin.

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

• HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
• exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
• HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
• Execution is timeout-bounded and concurrency-capped.
• Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.