Disease Information & Support

www.lls.org/diseaseinformation

The Word:

donate

Myeloma Staging

Your doctor will determine the extent of your myeloma by staging the disease according to how much myeloma is in your body. Staging helps your doctor predict the myeloma's progression and develop a treatment plan.

Doctors use one of two staging systems: the Durie-Salmon Staging System or the newer International Staging System. Doctors also use the terms smoldering myeloma or asymptomatic myeloma to describe the disease when its presence is minimal with little evidence of progression.

Durie-Salmon Staging System

The Durie-Salmon Staging System calculates the myeloma stage by measuring:

  • levels of hemoglobin
  • levels of monoclonal immunoglobulin (IG) (M protein) in the blood and urine
  • blood calcium levels
  • creatinine levels (which checks for kidney function)
  • bone damage, if any

Stage I

All must be present:

  • Hemoglobin level is greater than 10.5 grams per deciliter (g/dL)
  • Serum calcium level is normal or less than or equal to 12 milligrams per deciliter (mg/dL)
  • Low M-protein levels (IgG level is less than 5 g/dL; IgA level is less than 3 g/dL)
  • Urine light chains are less than 4 g per 24 hours
  • Bone X-ray shows normal bone structure (scale 0) or a solitary bone plasmacytoma
Stage IIA

All must be present:

  • Levels of hemoglobin, calcium, M-protein and Bence Jones protein fall somewhere between stages I and III
  • No kidney failure (creatinine level is 2 mg/dL or lower)
Stage IIB

All must be present:

  • Levels of hemoglobin, calcium, M-protein and Bence Jones protein fall somewhere between stages I and III
  • Kidney failure (creatinine level is greater than 2 mg/dL)
Stage III Both must be present:
  • High M protein levels (IgG level is greater than 7 g/dL; IgA value is greater than 5g/dL)
  • Urine light chains are greater than 12 g per 24 hours
  • Hemoglobin is less than 8.5 grams per deciliter (g/dL)
  • Serum calcium is greater than 12 miligrams per deciliter (m/dL)
  • X-ray studies of bone show greater than 3 lytic bone lesions

 

International Staging System

The International Staging System calculates the myeloma stage by measuring levels of two proteins in the blood:

  • beta 2-microglobulin
  • albumin

Stage I Both must be present:
  • Beta 2-microglobulin level is less than 3.5 mg per liter (L)
  • Albumin level is 3.5 g/dL or higher
Stage II
  • Beta 2-microglobulin level is less than 3.5 g/L and
  • Albumin level is less than 3.5 g/dL
    or
  • Beta 2-microglobulin level is 3.5 to 5.5 mg/L
Stage III
  • Beta 2-microglobulin level is 5.5 mg/L or higher

To develop a treatment approach, your doctor considers many factors along with staging.

Go back to:
» Myeloma
last updated on Wednesday, April 24, 2013
btn_sharethis

Get Information
& Support

Contact an Information Specialist.

Newly Diagnosed?