Multiple myeloma staging
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Multiple myeloma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Multiple myeloma staging On the Web |
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American Roentgen Ray Society Images of Multiple myeloma staging |
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Risk calculators and risk factors for Multiple myeloma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2] Shyam Patel [3]
Overview
Multiple myeloma may be divided into three stages based on either the International Staging System (ISS) or Durie-Salmon Staging System.[1] The International Staging System for multiple myeloma was published by the International Myeloma Working Group in 2003 and is the most widely used staging system.[1][2] It is used for both guiding treatment as well as predicting prognosis. The Durie-Salmon staging system, first published in 1975, is a clinical staging system for multiple myeloma that correlates measured myeloma cell mass to the presenting clinical features, response to treatment, and survival.[3] Durie-Salmon Staging System is still in use, but has been largely superseded by the more practical ISS and revised ISS [1]
Staging
- International Staging System
According to the International Staging System (ISS), there are three stages of multiple myeloma based on both β2-microglobulin and albumin levels:[1] [2]
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- Revised International Staging System
The Revised International Staging System (R-ISS) was proposed in 2015 and incorporated chromosomal aberrations and LDH level to more accurately risk stratify patients.[4]
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- Durie-Salmon Staging System
According to the Durie-Salmon Staging System, there are three stages of multiple myeloma based on the hemoglobin level, calcium level, skeletal survey, serum parapprotein level, and urinary light chain excretion:[1]
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Stages 1, 2 and 3 of the Durie-Salmon staging system can be divided into A or B depending on serum creatinine:[1]
- A: serum creatinine < 2mg/dL (< 177 umol/L)
- B: serum creatinine > 2mg/dL (> 177 umol/L)
- SWOG Staging System[5]
The Southwest Oncology Group (SWOG) staging system is not currently widely used. Unlike the other staging systems, there are four stages in the SWOG staging system.
| Stage | Features |
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References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 About multiple myeloma. University of California San Francisco (2015)http://cancer.ucsf.edu/research/multiple-myeloma/ Accessed on September, 18 2015
- ↑ 2.0 2.1 Greipp PR, San Miguel J, Fonseca R, Avet-Loiseau H, Jacobson JL, Rasmussen E, Crowley J, Durie BMG. Development of an international prognostic index (IPI) for myeloma: report of the international myeloma working group. Hematology Journal 2003;4:S42. NLM ID 100965523.
- ↑ Durie BG, Salmon SE (1975). "A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival". Cancer. 36 (3): 842–54. PMID 1182674.
- ↑ Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L; et al. (2015). "Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group". J Clin Oncol. 33 (26): 2863–9. doi:10.1200/JCO.2015.61.2267. PMC 4846284. PMID 26240224.
- ↑ Choi JH, Yoon JH, Yang SK (2007). "Clinical value of new staging systems for multiple myeloma". Cancer Res Treat. 39 (4): 171–4. doi:10.4143/crt.2007.39.4.171. PMC 2739370. PMID 19746184.