Multiple Myeloma ISS

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Use this calculator to determine prognosis in multiple myeloma using the International Staging System (ISS)

Beta 2 microglobulin
Albumin < 3.5 g/dL or 35 g/L

About this calculator

A combination of serum beta2-microglobulin (B2M) and albumin (Ab) provides the simplest and most powerful three-stage prognostic system. The new International Staging System has been validated in patients from North America, Europe, Asia; in patient less than or greater than age 65; and in patients receiving conservative therapy or high-dose therapy en route to autologous transplantation. Based exclusively on the beta 2 microglobulin and albumin levels at diagnosis, the ISS relies on simple and available lab parameters, and thus may be more objective than previous staging systems, including the Salmon-Durie system based on clinical variables. B2M is thought to reflect underlying tumor burden, renal, and potentially immune function, while the prognostic significance of albumin is not completely understood, although it is hypothesized that IL-6 produced in the myeloma microenvironment may impair hepatic albumin production.

Citations

The new ISS system was developed and published by Greipp PR et al. International Staging System for Multiple Myeloma. JCO 23:3412-3420. (2005)

A prior well known prognostic and staging system was developed by Salmon and Durie in 1975.

Durie BGM, Salmon SE. A clinical staging system for multiple myeloma. Cancer 36:842-854. (1975)

Contributor

QxMD Hematology contributing author: Dr. Matthew Cheung, MD, SM, FRCP(C)