Multiple myeloma staging: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Multiple myeloma}} | {{Multiple myeloma}} | ||
{{CMG}} {{AE}} {{HMHJ}} | {{CMG}} {{AE}} {{HMHJ}}; {{HL}}; {{shyam}} | ||
==Overview== | ==Overview== | ||
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==Staging== | ==Staging== | ||
;'''International Staging System''' | ;'''International Staging System''' | ||
According to the International Staging System (ISS), there are three stages of [[multiple myeloma]] based on both [[Beta-2 microglobulin|β<sub>2</sub>-microglobulin]] and [[albumin]] levels:<ref name="California">About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015 </ref> <ref name="ISS">Greipp PR, San Miguel J, Fonseca R, Avet-Loiseau H, Jacobson JL, Rasmussen E, Crowley J, Durie BMG. Development of an international prognostic index (IPI) for myeloma: report of the international myeloma working group. ''Hematology Journal'' 2003;4:S42. NLM ID 100965523.</ref> | According to the International Staging System (ISS), there are three stages of [[multiple myeloma]] based on both [[Beta-2 microglobulin|β<sub>2</sub>-microglobulin]] and [[albumin]] levels:<ref name="California">About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015 </ref> <ref name="ISS">Greipp PR, San Miguel J, Fonseca R, Avet-Loiseau H, Jacobson JL, Rasmussen E, Crowley J, Durie BMG. Development of an international prognostic index (IPI) for myeloma: report of the international myeloma working group. ''Hematology Journal'' 2003;4:S42. NLM ID 100965523.</ref> | ||
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According to the Durie-Salmon Staging System, there are three stages of [[multiple myeloma]] based on the [[hemoglobin]] level, [[calcium]] level, [[skeletal survey]], serum [[paraprotein]] level, and urinary [[light chain]] excretion:<ref name="California">About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015 </ref> | According to the Durie-Salmon Staging System, there are three stages of [[multiple myeloma]] based on the [[hemoglobin]] level, [[calcium]] level, [[skeletal survey]], serum [[paraprotein]] level, and urinary [[light chain]] excretion:<ref name="California">About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015 </ref> | ||
{| style=" | {| style="border: 0px; font-size: 100%; margin: 3px; width: 1000px" | ||
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! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Stage}} | ! style="background: #4479BA; width: 300px;" | {{fontcolor|#FFF|Stage}} | ||
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* A: [[serum creatinine]] < 2mg/dL (< 177 umol/L) | * A: [[serum creatinine]] < 2mg/dL (< 177 umol/L) | ||
* B: [[serum creatinine]] > 2mg/dL (> 177 umol/L) | * B: [[serum creatinine]] > 2mg/dL (> 177 umol/L) | ||
;'''SWOG Staging System'''<ref name="pmid19746184">{{cite journal| author=Choi JH, Yoon JH, Yang SK| title=Clinical value of new staging systems for multiple myeloma. | journal=Cancer Res Treat | year= 2007 | volume= 39 | issue= 4 | pages= 171-4 | pmid=19746184 | doi=10.4143/crt.2007.39.4.171 | pmc=2739370 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19746184 }} </ref> | ;'''SWOG Staging System'''<ref name="pmid19746184">{{cite journal| author=Choi JH, Yoon JH, Yang SK| title=Clinical value of new staging systems for multiple myeloma. | journal=Cancer Res Treat | year= 2007 | volume= 39 | issue= 4 | pages= 171-4 | pmid=19746184 | doi=10.4143/crt.2007.39.4.171 | pmc=2739370 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19746184 }} </ref> | ||
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:[[beta-2-microglobulin|β<sub>2</sub>-microglobulin]]>5.5 mg/L ''and'' albumin <3 g/dl | :[[beta-2-microglobulin|β<sub>2</sub>-microglobulin]]>5.5 mg/L ''and'' albumin <3 g/dl | ||
|} | |} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Medicine]] | |||
[[Category: | |||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Neurosurgery]] | [[Category:Neurosurgery]] | ||
[[Category:Oncology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Primary care]] | |||
[[Category:Surgery]] |
Revision as of 20:58, 3 December 2018
Multiple myeloma Microchapters |
Diagnosis |
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Treatment |
Case Studies |
Multiple myeloma staging On the Web |
American Roentgen Ray Society Images of Multiple myeloma staging |
Risk calculators and risk factors for Multiple myeloma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hannan Javed, M.D.[2]; Haytham Allaham, M.D. [3]; Shyam Patel [4]
Overview
Multiple myeloma may be divided into three stages based on either the International Staging System (ISS) or Durie-Salmon Staging System.[1] The International Staging System for multiple myeloma was published by the International Myeloma Working Group in 2003 and is the most widely used staging system.[1][2] It is used for both guiding treatment as well as predicting prognosis. The Durie-Salmon staging system, first published in 1975, is a clinical staging system for multiple myeloma that correlates measured myeloma cell mass to the presenting clinical features, response to treatment, and survival.[3] Durie-Salmon Staging System is still in use, but has been largely superseded by the more practical ISS and revised ISS [1]
Staging
- International Staging System
According to the International Staging System (ISS), there are three stages of multiple myeloma based on both β2-microglobulin and albumin levels:[1] [2]
Stage | Features | Prognosis |
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- Revised International Staging System
The Revised International Staging System (R-ISS) was proposed in 2015 and incorporated chromosomal aberrations and LDH level to more accurately risk stratify patients.[4]
Stage | Features | Prognosis |
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Not Stage 1 or Stage 3 |
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- Durie-Salmon Staging System
According to the Durie-Salmon Staging System, there are three stages of multiple myeloma based on the hemoglobin level, calcium level, skeletal survey, serum paraprotein level, and urinary light chain excretion:[1]
Stage | Hemoglobin level | Calcium level | Skeletal survey | Serum paraprotein level | Urinary light chain excretion |
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Stages 1, 2 and 3 of the Durie-Salmon staging system can be divided into A or B depending on serum creatinine:[1]
- A: serum creatinine < 2mg/dL (< 177 umol/L)
- B: serum creatinine > 2mg/dL (> 177 umol/L)
- SWOG Staging System[5]
The Southwest Oncology Group (SWOG) staging system is not currently widely used. Unlike the other staging systems, there are four stages in the SWOG staging system.
Stage | Features |
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β2-microglobulin <2.5 mg/L |
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β2-microglobulin >2.5 mg/L and <5.5 mg/L |
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References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015
- ↑ 2.0 2.1 Greipp PR, San Miguel J, Fonseca R, Avet-Loiseau H, Jacobson JL, Rasmussen E, Crowley J, Durie BMG. Development of an international prognostic index (IPI) for myeloma: report of the international myeloma working group. Hematology Journal 2003;4:S42. NLM ID 100965523.
- ↑ Durie BG, Salmon SE (1975). "A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival". Cancer. 36 (3): 842–54. PMID 1182674.
- ↑ Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L; et al. (2015). "Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group". J Clin Oncol. 33 (26): 2863–9. doi:10.1200/JCO.2015.61.2267. PMC 4846284. PMID 26240224.
- ↑ Choi JH, Yoon JH, Yang SK (2007). "Clinical value of new staging systems for multiple myeloma". Cancer Res Treat. 39 (4): 171–4. doi:10.4143/crt.2007.39.4.171. PMC 2739370. PMID 19746184.