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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!
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!
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