How Is Multiple Myeloma Staged and Classified?

The revised International Staging System (R-ISS), updated in 2015, was based on data from 4,445 newly diagnosed multiple myeloma patients across 11 clinical trials.

Myeloma experts were already aware that high Beta-2 microglobulin and low albumin levels indicated higher-risk myeloma. The update incorporated new insights into high-risk genetic features and elevated LDH levels, which are now included in the staging system.

To learn more about the revised International Staging System, click here. 

R-ISS Stage I

Criteria	Test Type	Results
Beta 2 microglobulin	Blood	Less than 3.5 mg/L
Albumin	Blood	Greater than 3.5 g/dL
Genetics	Bone marrow biopsy	Standard-risk chromosomal abnormalities by FISH
LDH	Blood	At or under normal LDH levels

R-ISS Stage II (Neither Stage I nor Stage III)

Criteria	Test Type	Results
Beta 2 microglobulin	Blood	Between 3.5 - 5.5 mg/L OR
Albumin	Blood	Less than 3.5 g/dL

R-ISS Stage III

Criteria	Test Type	Results
Beta 2 microglobulin	Blood	Over 5.5 mg/L
Albumin	Blood	Greater than 3.5 g/dL
Genetics	Bone marrow biopsy	High risk chromosomal abnormalities including del 17p, translocation 4;14 or translocation 14;16 by FISH OR
LDH	Blood	LDH over normal levels

 

Learn more as Dr. Muzaffar Quazilbash of the MD Anderson Cancer Center explains myeloma staging in HealthTree University.

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If you are curious about your myeloma staging, you can privately connect your electronic health records and track your myeloma labs through HealthTree Cure Hub. Create a free profile today!

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