Sandbox/00038: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 2: Line 2:
{{Plasma cell neoplasm}}
{{Plasma cell neoplasm}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Ammu}}
==Overview==
The Durie-Salmon staging system has been widely adopted to stratify patients with [[multiple myeloma]] since 1975. It provides a fair estimate on the tumor burden but has limitations in the categorization of bone lesions.<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><ref>{{Cite journal | issn = 1066-5099 | volume = 13 Suppl 2 | pages = 56–63 | last = Kyle | first = R A | title = Prognostic factors in multiple myeloma | journal = Stem cells (Dayton, Ohio) | date = 1995-08 | pmid = 8520513 }}</ref><ref>{{Cite journal | issn = 0038-2469 | volume = 79 | issue = 2 | pages = 65–67 | last = Rapoport | first = B L | coauthors = H C Falkson, G Falkson | title = Prognostic factors affecting the survival of patients with multiple myeloma. A retrospective analysis of 86 patients | journal = South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde | date = 1991-01-19 | pmid = 1989088 }}</ref> The International Staging System overcomes the limitations of Durie-Salmon system by dividing patients based on the [[serum]] levels of [[beta-2 microglobulin|β2-microglobulin]] and [[albumin]].<ref>{{Cite journal | doi = 10.1200/JCO.2005.04.242 | issn = 0732-183X | volume = 23 | issue = 15 | pages = 3412–3420 | last = Greipp | first = Philip R | coauthors = Jesus San Miguel, Brian G M Durie, John J Crowley, Bart Barlogie, Joan Bladé, Mario Boccadoro, J Anthony Child, Herve Avet-Loiseau, Jean-Luc Harousseau, Robert A Kyle, Juan J Lahuerta, Heinz Ludwig, Gareth Morgan, Raymond Powles, Kazuyuki Shimizu, Chaim Shustik, Pieter Sonneveld, Patrizia Tosi, Ingemar Turesson, Jan Westin | title = International staging system for multiple myeloma | journal = Journal of clinical oncology: official journal of the American Society of Clinical Oncology | date = 2005-05-20 | pmid = 15809451 }}</ref> Both Durie-Salmon Staging System and International Staging System are useful for assessing the prognosis of a patient with [[multiple myeloma]]. However, neither of them are favorable in making therapeutic options.


==Staging==
==Staging==

Revision as of 02:26, 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]

Overview

The Durie-Salmon staging system has been widely adopted to stratify patients with multiple myeloma since 1975. It provides a fair estimate on the tumor burden but has limitations in the categorization of bone lesions.[1][2][3] The International Staging System overcomes the limitations of Durie-Salmon system by dividing patients based on the serum levels of β2-microglobulin and albumin.[4] Both Durie-Salmon Staging System and International Staging System are useful for assessing the prognosis of a patient with multiple myeloma. However, neither of them are favorable in making therapeutic options.

Staging

Durie-Salmon Staging System

This system is based on 4 factors:[5]

  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:[6]

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)

International Staging System

This system divides myeloma into 3 stages based only on the serum beta-2 microglobulin and serum albumin levels.[5]

References

  1. ↑ 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)
  2. ↑ Kyle, R A (1995-08). "Prognostic factors in multiple myeloma". Stem cells (Dayton, Ohio). 13 Suppl 2: 56–63. ISSN 1066-5099. PMID 8520513. Check date values in: |date= (help)
  3. ↑ Rapoport, B L (1991-01-19). "Prognostic factors affecting the survival of patients with multiple myeloma. A retrospective analysis of 86 patients". South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 79 (2): 65–67. ISSN 0038-2469. PMID 1989088. Unknown parameter |coauthors= ignored (help)
  4. ↑ Greipp, Philip R (2005-05-20). "International staging system for multiple myeloma". Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 23 (15): 3412–3420. doi:10.1200/JCO.2005.04.242. ISSN 0732-183X. PMID 15809451. Unknown parameter |coauthors= ignored (help)
  5. ↑ 5.0 5.1 "How is multiple myeloma staged?".
  6. ↑ 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)
Retrieved from "https://www.wikidoc.org/index.php?title=Sandbox/00038&oldid=980723"