A person must have >10 % clonal plasma cells and any MDE to be diagnosed with myeloma. The biomarker criteria were added so that smouldering people with multiple myeloma at high risk of developing multiple myeloma could be diagnosed before organ damage occurred, so they would therefore have a better prognosis. Asymptomatic/smoldering myeloma:
Serum M protein >30 g/L (3 g/dL) or
Clonal plasma cells >10% on bone marrow biopsy and
No myeloma-related organ or tissue impairment
Monoclonal gammopathy of undetermined significance (MGUS):
Serum paraprotein <30 g/L (3 g/dL) and
Clonal plasma cells <10% on bone marrow biopsy and
No myeloma-related organ or tissue impairment or a related B-cell lymphoproliferative disorderRelated conditions include solitary plasmacytoma (a single tumor of plasma cells, typically treated with irradiation), plasma cell dyscrasia (where only the antibodies produce symptoms, e.g., AL amyloidosis), and peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes. Staging
In multiple myeloma, staging helps with prognostication but does not guide treatment decisions. The Durie-Salmon staging system was used historically and was replaced by the International Staging System (ISS), published by the International Myeloma Working Group In 2005. The revised ISS (R-ISS) was published in 2015 and incorporates cytogenetics and lactate dehydrogenase (LDH). : 1730–1 : 732–3 
Stage I: β2 microglobulin (β2M) < 3.5 mg/L, albumin ≥ 3.5 g/dL, normal cytogenetics, no elevated LDH
Stage II: Not classified under Stage I or Stage III
Stage III: β2M ≥ 5.5 mg/L and either elevated LDH or high-risk cytogenetics [t(4,14), t(14,16), and/or del(17p)]

Prevention
The risk of multiple myeloma can be reduced slightly by maintaining a normal body weight.
Side effects
The main side effect of thiotepa is bone marrow suppression resulting in leukopenia, thrombocytopenia and anemia. Liver and lung toxicity may also occur. History
Thiotepa was developed by the American Cyanamid company in the early 1950s and reported to media outlets in 1953. In 1959, thiotepa was registered with the Food and Drug Administration (FDA) as a drug therapy for several solid cancers.On January 29, 2007, the European Medicines Agency (EMA) designated thiotepa as an orphan drug. On April 2, 2007, the United States FDA designated thiotepa as a conditioning treatment for use prior to hematopoietic stem cell transplantation. Adienne Pharma & Biotech (Italy), the owner of thiotepa (Tepadina) applied for these designations. References
External links
"Thiotepa". Drug Information Portal. U.S. National Library of Medicine.