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Myeloma Staging

Doctors use imaging and laboratory test results and bone marrow examination findings to determine the extent of disease. This determination is called 鈥渟taging.鈥� Staging helps your doctor predict the myeloma's progression and develop a treatment plan.

Myeloma has three stages numbered from 1 to 3. Often doctors write the stage in Roman numerals. You may see stage 1 written as Stage I, stage 2 written as Stage II and stage 3 written as Stage III.

The stage tells your doctor how quickly your myeloma is growing. Stage 1 myeloma typically grows slowly. As the stages get higher, the myeloma typically grows more quickly. Knowing the stage can help your doctor predict your prognosis (likely outcome of the disease). Doctors use the results of blood, bone marrow and imaging tests to stage myeloma. These tests look at: 

  • Hemoglobin levels in the blood, which may be lower than normal
  • The amount of M protein found in the blood and urine (M protein is made by myeloma cells)
  • The calcium level in the blood, which may be higher than normal
  • The Beta-2 microglobulin level in the blood, which may be higher than normal
  • The albumin level in the blood, which may be lower than normal
  • The bones, to see if there are any bone lesions
  • The presence of high-risk cytogenetic (chromosome) abnormalities in the myeloma cells
  • The lactate dehydrogenase level in the blood, which may be higher than normal 

There are two staging systems that are commonly used in myeloma. One is called the Durie-Salmon Staging System, and the other is called the Revised International Staging System (R-ISS) for Multiple Myeloma.

In treatment planning, doctors also consider other factors. The general health of the patient, the presence of other significant diseases such as heart disease or diabetes, the presence of kidney disease, other findings that influence the patient鈥檚 tolerance to treatment, and the risk of treatment-induced difficulties are all considered when doctors are making treatment decisions, including whether to treat and what approach to take.

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