"The revised staging system can be used by doctors to discuss prognostic results very carefully with individual patients," said Dr. Brian G.M. Durie, IMF and IMWG Chairman. "It's helpful to know the expectations and consider how treatments can be modified based on the new ISS system." The revised guidelines, or R-ISS, adds tests for chromosomal abnormalities (CA) and serum lactate dehydrogenase (LDH) to the earlier ISS to refine its prognostic value in newly diagnosed myeloma patients. This updating of the myeloma classification system is part of a larger revolution in the diagnosis and treatment of myeloma - a shift toward biomarkers that are increasingly more sensitive and specific, according to Dr. Durie. While the existing ISS relies on tests for serum beta 2 microglobulin and serum albumin to divide patients into three risk-factor stages, the JCO paper recommends adding interphase Fluorescence In Situ Hybridization (iFISH) to check for CA, along with separate tests for heightened LDH. The two new tests determine more definitively if a patient is in Stage III, while conversely, per the new protocols, a Stage I patient would have normal chromosomes and LDH.