Myeloma Staging Systems | ||
| Durie-Salmon staging system | ||
|---|---|---|
| STAGE | CRITERIA | ESTIMATED TUMOR BURDEN × 1012 CELLS/m2 |
| I | All of the following: | <0.6 (low) |
| 1. Hemoglobin >100 g/L (>10 g/dL) | ||
| 2. Serum calcium<3 mmol/L (<12 mg/dL) | ||
| 3. Normal bone x-ray or solitary lesion | ||
| 4. Low M-component production | ||
| a. IgG level <50 g/L (<5 g/dL) | ||
| b. IgA level <30 g/L (<3 g/dL) | ||
| c. Urine light chain <4 g/24 h | ||
| II | Fitting neither I nor III | 0.6-1.20 (intermediate) |
| III | One or more of the following: | >1.20 (high) |
| 1. Hemoglobin <85 g/L (<8.5 g/dL) | ||
| 2. Serum calcium >3 mmol/L (>12 mg/dL) | ||
| 3. Advanced lytic bone lesions | ||
| 4. High M-component production | ||
| a. IgG level >70 g/L (>7 g/dL) | ||
| b. IgA level >50 g/L (>5 g/dL) | ||
| c. Urine light chains >12 g/24 h | ||
| LEVEL | STAGE | MEDIAN SURVIVAL, MONTHS |
| Subclassification based on serum creatinine levels | ||
| A <177 µmol/L (<2 mg/dL) | IA | 61 |
| B >177 µmol/L (>2 mg/dL) | IIA, B | 55 |
| IIIA | 30 | |
| IIIB | 15 | |
| International staging system | ||
| β2M <3.5, alb ≥3.5 | I (28%) | 62 |
| β2M <3.5, alb <3.5 orβ2M = 3.5-5.5 | II (39%) | 44 |
| β2M >5.5 | III (33%) | 29 |
Note:β2M, serum β2-microglobulin in mg/L; alb, serum albumin in g/dL; (#), % pts presenting at each stage.