This article first appeared on the Multiple Myeloma Research Foundation website and is reprinted here with their permission.
Staging Multiple Myeloma
The stages of multiple myeloma are used to indicate the degree to which the cancer has progressed. Doctors use the results of diagnostic testing to determine the stage of myeloma. While there are many factors that affect myeloma survival rates, the stage of myeloma helps doctors determine the prognosis, or the likely outcome of the disease. Moreover, staging myeloma is important for developing the most effective treatment plan.
How is Multiple Myeloma Staged?
The international staging system (ISS) is the most commonly used myeloma staging system. It is based on two blood test results, beta 2-microglobulin (ß2-M) and albumin. ß2-M is a protein that indicates the extent of disease and albumin in an indicator of overall general health.
The Durie-Salmon Staging System is an older staging system that is sometimes still used. With the Durie-Salmon Staging System, the stage of myeloma is determined by four measurements: the amount of hemoglobin and the level of calcium in the blood, the number of bone lesions, and the production rate of M protein. Stages are then further divided according to kidney function. Increasingly, physicians are relying less on the Durie-Salmon staging system and more on biologically relevant markers as prognostic indicators when making treatment choices.
Staging also plays a role in the classification of multiple myeloma.There is somewhat of an overlap between the various myeloma classifications and myeloma stages from both systems. For example, both patients with smoldering myeloma and patients with Stage I disease do not require immediate treatment, and patients with Stage II and III disease have active, symptomatic myeloma.
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