Sandbox:Haytham

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

Durie-Salmon staging system

First published in 1975, the Durie-Salmon staging system is still in use, but has largely been superseded by the simpler ISS:

• stage 1: all of
  • Hb > 10g/dL
  • normal calcium
  • Skeletal survey: normal or single plasmacytoma or osteoporosis
  • Serum paraprotein level < 5 g/dL if IgG, < 3 g/dL if IgA
  • Urinary light chain excretion < 4 g/24h
• stage 2: fulfilling the criteria of neither 1 nor 3
• stage 3: one or more of
  • Hb < 8.5g/dL
  • high calcium > 12mg/dL
  • Skeletal survey: 3 or more lytic bone lesions
  • Serum paraprotein >7g/dL if IgG, > 5 g/dL if IgA
  • Urinary light chain excretion > 12g/24h

Stage	Hemoglobin level	Calcium level	Skeletal survey	Serum paraprotein level	Urinary light chain excretion
Stage 1	> 10g/dL	8.5-10.2 mg/dL	Normal or single plasmacytoma or osteoporosis	< 5 g/dL if IgG or < 3 g/dL if IgA	< 4 g/24h
Stage 2	8.5-10g/dL	10.2-12 mg/dL	fulfilling the criteria of neither 1 nor 3	5-7 g/dL if IgG or 3-5 g/dL if IgA	4-12 g/24h
Stage 3	< 8.5g/dL	> 12mg/dL	3 or more lytic bone lesions	>7g/dL if IgG or > 5 g/dL if IgA	> 12g/24h