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How Is Multiple Myeloma Staged and Classified?

Multiple myeloma staging and classification can be complicated, so let's break it down.

What Are the Stages of Multiple Myeloma? 

Staging in multiple myeloma is different from that in solid tumors. While solid tumor staging reflects tumor size and spread, multiple myeloma is a blood cancer that’s inherently "metastatic" because it affects the blood and bone marrow.

Myeloma staging focuses on protein levels, kidney function, and bone damage, but it’s less predictive of patient outcomes. As you consider your diagnosed "stage," remember that myeloma staging serves a different purpose and may not closely predict prognosis.

What Is the Revised International Staging System (R-ISS) for Multiple Myeloma? 

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.

Learn Your Staging of Myeloma

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!

HealthTree Cure Hub

Multiple myeloma staging and classification can be complicated, so let's break it down.

What Are the Stages of Multiple Myeloma? 

Staging in multiple myeloma is different from that in solid tumors. While solid tumor staging reflects tumor size and spread, multiple myeloma is a blood cancer that’s inherently "metastatic" because it affects the blood and bone marrow.

Myeloma staging focuses on protein levels, kidney function, and bone damage, but it’s less predictive of patient outcomes. As you consider your diagnosed "stage," remember that myeloma staging serves a different purpose and may not closely predict prognosis.

What Is the Revised International Staging System (R-ISS) for Multiple Myeloma? 

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.

Learn Your Staging of Myeloma

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!

HealthTree Cure Hub

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