Staging the Multiple myeloma

To determine the best treatments for multiple myeloma, we need to ascertain the stage of the disease, particularly the rate of growth and the presence of kidney complications or other serious symptoms. Normally, in most oncological diseases, this estimate is based on the size and spread of tumors within the body. To accurately determine the stage of the cancer (in this case multiple myeloma), several quantitative parameters are examined: the blood cell count, the amount of protein present in the blood and urine, the level of blood calcium and other diagnostic test results.

Evaluation methods

There are two methods of recognizing and ordering the stages of evil: the Durie-Salmon and the Revised International Staging System. Both are divided into 3 phases, numbered from I to III, and differ in the factors that are evaluated.
With the Durie-Salmon system, less used, the levels of monoclonal immunoglobulin, calcium and hemoglobin in the blood, as well as the number of bone lesions, are taken into account. The International Staging System essentially observes: the levels of albumin, beta-2 microglobulin in the blood.

Multiple Myeloma Stages

Stage 0

The Asymptomatic myeloma (also known as smoldering myeloma) is a slow-growing type of multiple myeloma characterized by an increase in plasma cells in the bone marrow and the presence of monoclonal proteins.

Stage 1

Tests show low myeloma cell counts, beta-2 microglobulin levels slightly above normal (below 3.5 mg / L), decreased albumin levels (3.5 (g / dL) or greater).

Stage 2

This is an intermediate stage, where the levels tested fall between the standards set for stage I and stage III.

Stage 3

At this stage, the number of myeloma cells is considered to be high, being characterized by high levels of beta-2 microglobulin (5.5 (mg / L) or greater) and low levels of albumin.

Other factors

Kidney function

Proper kidney function is evidenced by an adequate level of creatinine in the blood. Normally, this chemical is cleared by the kidneys, but when damaged by monoclonal immunoglobulin, these levels tend to rise, opening the door to pejorative prospects.


Inevitably, age weighs heavily; thus, older people with myeloma don’t live that long.

General health

Poor general health, such as that of people with diabetes or heart disease, influences the course of the disease, leading to a worse prognosis.

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