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Classification & Staging

Staging myeloma

Once active multiple myeloma has been diagnosed, doctors will want to determine the extent – or stage – of the disease.

Knowing the stage of the myeloma helps doctors understand how serious the disease is, establish a customized treatment plan, and arrive at a prognosis (an estimate of how the disease will progress). 

Several systems are used to stage active myeloma. The two main systems are the International Staging System (ISS) and the Durie Salmon Staging System. 

International Staging System (ISS) Durie Salmon Staging System

Based upon two blood test results:

  • Beta 2 microglobulin (ß2M) – Higher-than-normal levels of this protein indicate inflammation somewhere in the body, and/or may indicate some types of white blood cell disorders.
  • Albumin – Lower levels of this form of protein (the most common one found in blood plasma) may indicate impaired kidney function. 

Requires a number of other blood tests, including:

  • Hemoglobin (Hb) – Abnormally low levels of the red blood cells that carry and release oxygen may indicate anemia.
  • Serum calcium – Too much calcium in the blood can be a sign of bone disease.
  •  Serum monoclonal proteins – This refers to the level of individual M-proteins (such as IgG, IgA, etc.) or free light chains.
  • Serum creatinine – Levels of creatinine may be elevated when kidney function is abnormal.   

In both systems, active myeloma is staged according to its extent at the time of diagnosis. There are three possible stages, referred to as Stage I, Stage II and Stage III, in order of increasing disease severity. 

For more information, downlaod the Multiple Myeloma Patient Handbook
Designed to provide educational support to patients, caregivers, families, and friends, this handbook gives accurate, reliable, and clear information on myeloma. Topics cover its causes and effects, how it is diagnosed, and the treatment options available in Canada.
Download it now.