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===Durie-Salmon Staging System===
===Durie-Salmon Staging System===


This system is based on 4 factors:<ref name="www.cancer.org">{{Cite web | title = How is multiple myeloma staged? | url = http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-staging}}</ref><ref>{{Cite journal | issn = 0008-543X | volume = 36 | issue = 3 | pages = 842–854 | last = Durie | first = B G | coauthors = S E Salmon | title = A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival | journal = Cancer | date = 1975-09 | pmid = 1182674 }}</ref>
This system is based on 4 factors:<ref name="www.cancer.org">{{Cite web | title = How is multiple myeloma staged? | url = http://www.cancer.org/cancer/multiplemyeloma/detailedguide/multiple-myeloma-staging}}</ref>
# The amount of abnormal monoclonal immunoglobulin in the blood or urine: Large amounts of monoclonal immunoglobulin indicate that many malignant plasma cells are present and are producing that abnormal protein.
# '''The amount of abnormal monoclonal immunoglobulin in the blood or urine'''. Large amounts of monoclonal immunoglobulin indicate that significant malignant plasma cells are present and are producing that abnormal protein.
# The amount of calcium in the blood: High blood calcium levels can be related to advanced bone damage. Because bone normally contains lots of calcium, bone destruction releases calcium into the blood.
# '''The amount of calcium in the blood'''. High blood calcium levels can be related to advanced bone resorption.
# The severity of bone damage based on x-rays: Multiple areas of bone damage seen on x-rays indicate an advanced stage of multiple myeloma.
# '''The severity of bone damage based on X-rays'''. Multiple areas of bone damage seen on X-rays indicate an advanced stage of multiple myeloma.
# The amount of hemoglobin in the blood: Hemoglobin carries oxygen in red blood cells. Low hemoglobin levels mean you are anemic and can indicate that the myeloma cells occupy much of the bone marrow and that not enough space is left for the normal marrow cells to make enough red blood cells.
# '''The amount of hemoglobin in the blood'''. Low hemoglobin levels indicate that the myeloma cells occupy much of the bone marrow and that not enough space is left for the normal marrow cells to make enough red blood cells.


This system uses these factors to divide myeloma into 3 stages. Stage I indicates the smallest amount of tumor, and stage III indicates the largest amount of tumor. The table below describes the criteria for the Durie-Salmon staging system:
This system uses these factors to divide myeloma into 3 stages. Stage I indicates the smallest amount of tumor, and stage III indicates the largest amount of tumor. The table below describes the criteria for the Durie-Salmon staging system:<ref>{{Cite journal | issn = 0008-543X | volume = 36 | issue = 3 | pages = 842–854 | last = Durie | first = B G | coauthors = S E Salmon | title = A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival | journal = Cancer | date = 1975-09 | pmid = 1182674 }}</ref>


{|style="border: 0px; font-size: 90%; margin: 0px;"
! style="background: #4479BA; padding: 5px 5px; font-weight: bold;" | {{fontcolor|#FFFFFF|Stage}}
! style="background: #4479BA; padding: 5px 5px; font-weight: bold;" | {{fontcolor|#FFFFFF|Criteria}}
! style="background: #4479BA; padding: 5px 5px; font-weight: bold;" | {{fontcolor|#FFFFFF|Cell Mass (x10<sup>12</sup>/m<sup>2</sup>)}}
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold; text-align: center; vertical-align: top;" | I
| style="background: #F5F5F5; padding: 0 5px;" valign=top | All of the following:
* Hemoglobin value &gt;10 g/dL
* Serum calcium value normal (≤12 mg/dL)
* On radiograph, normal bone structure (scale 0) or solitary bone plasmacytoma only
* Low M-component production rates
:* IgG value &lt;5 g/dL
:* IgA value &lt;3 g/dL
:* Urine light chain M-component on electrophoresis &lt;4 g/24 hours
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold; text-align: center; vertical-align: top;" | &lt;0.6 (Low)
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold; text-align: center; vertical-align: top;" | II
| style="background: #F5F5F5; padding: 0 5px;" valign=top | Fitting neither Stage I nor Stage III
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold; text-align: center; vertical-align: top;" | 0.6–1.2 (Intermediate)
|-
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold; text-align: center; vertical-align: top;" | III
| style="background: #F5F5F5; padding: 0 5px;" valign=top | One or more of the following:
* Hemoglobin value &lt;8.5 g/dL
* Serum calcium value &gt;12 mg/dL
* Advacned lytic bone lesions (scale 3)
* High M-component production rates
:* IgG value &gt;7 g/dL
:* IgA value &gt;5 g/dL
:* Urine light chain M-component on electrophoresis &gt;12 g/24 hours
| style="background: #DCDCDC; padding: 0 5px; font-weight: bold; text-align: center; vertical-align: top;" | &gt;1.2 (High)
|}




Revision as of 02:15, 22 June 2014

Template:Plasma cell neoplasm Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Staging

Durie-Salmon Staging System

This system is based on 4 factors:[1]

  1. The amount of abnormal monoclonal immunoglobulin in the blood or urine. Large amounts of monoclonal immunoglobulin indicate that significant malignant plasma cells are present and are producing that abnormal protein.
  2. The amount of calcium in the blood. High blood calcium levels can be related to advanced bone resorption.
  3. The severity of bone damage based on X-rays. Multiple areas of bone damage seen on X-rays indicate an advanced stage of multiple myeloma.
  4. The amount of hemoglobin in the blood. Low hemoglobin levels indicate that the myeloma cells occupy much of the bone marrow and that not enough space is left for the normal marrow cells to make enough red blood cells.

This system uses these factors to divide myeloma into 3 stages. Stage I indicates the smallest amount of tumor, and stage III indicates the largest amount of tumor. The table below describes the criteria for the Durie-Salmon staging system:[2]

Stage Criteria Cell Mass (x1012/m2)
I All of the following:
  • Hemoglobin value >10 g/dL
  • Serum calcium value normal (≤12 mg/dL)
  • On radiograph, normal bone structure (scale 0) or solitary bone plasmacytoma only
  • Low M-component production rates
  • IgG value <5 g/dL
  • IgA value <3 g/dL
  • Urine light chain M-component on electrophoresis <4 g/24 hours
 <0.6 (Low)
II Fitting neither Stage I nor Stage III 0.6–1.2 (Intermediate)
III One or more of the following:
  • Hemoglobin value <8.5 g/dL
  • Serum calcium value >12 mg/dL
  • Advacned lytic bone lesions (scale 3)
  • High M-component production rates
  • IgG value >7 g/dL
  • IgA value >5 g/dL
  • Urine light chain M-component on electrophoresis >12 g/24 hours
 >1.2 (High)


References

  1. ↑ "How is multiple myeloma staged?".
  2. ↑ Durie, B G (1975-09). "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): 842–854. ISSN 0008-543X. PMID 1182674. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)
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