Multiple myeloma staging
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Risk calculators and risk factors for Multiple myeloma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Staging
- International Staging System
The International Staging System (ISS) for myeloma was published by the International Myeloma Working Group in 2003 [1]:
- Stage I: β2-microglobulin (β2M) < 3.5 mg/L, albumin >= 3.5 g/dL
- Stage II: β2M < 3.5 and albumin < 3.5; or β2M between 3.5 and 5.5
- Stage III: β2M > 5.5
- Durie-Salmon staging system
First published in 1975, the Durie-Salmon staging system [2] is still in use, but has largely been superseded by the simpler ISS: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
Stages 1, 2 and 3 of the Durie-Salmon staging system can be divided into A or B depending on serum creatinine:
- A: serum creatinine < 2mg/dL (< 177 umol/L)
- B: serum creatinine > 2mg/dL (> 177 umol/L)
References
- ↑ 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. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival. Cancer 1975;36:842–854. PMID 1182674.