Imwg revised international staging system r iss for multiple myeloma. Multiple myeloma prognosis r iss revised international staging system for myeloma cllipi the international prognostic index for patients with chronic lymphocytic leukemia expected spleen size provides upper limit of normal for spleen length and volume by ultrasound relative to body height and gender. Asymptomatic myeloma prognosis, myeloma diagnosis, iss staging, response criteria mgus. An international staging system iss for multiple myeloma article in journal of clinical oncology 2315. Stages of multiple myeloma canadian cancer society. It divides mm cases into three groups on the basis of only two laboratory parameters table 1. Prognostication tool for myeloma patients based on the genetics and other routinely used lab values in. Healthdaythe international staging system iss combined with chromosomal abnormalities ca detected by interphase fluorescent in situ hybridization after cd8 plasma cell purification and. The revised multiple myeloma international staging system iss stages multiple myeloma. Prognostic comparison between iss and riss in reallife setting. Because staging criteria differ according to different groups, some clinicians simply define the individuals multiple myeloma without assigning a stage and simply estimate a prognosis see below for their patient. Updated diagnostic criteria and staging system for. It is my pleasure to be with you today to discuss the socalled riss, which is basically a revised international staging system designed to further assess risk. The iss was recently revised to include an elevated lactate dehydrogenase ldh level or the presence of highrisk cytogenetic abnormalities to create a more powerful.
A multiple myeloma prognosis is determined by both the number and specific properties of myeloma cells in a given patient. Alternative multiple myeloma staging proposal by multibilly on wed jul 16, 2014 3. Each system has stages i to iii, but they do not mean the same thing. The following table details the stages and criteria for measuring the presence and staging multiple myeloma. An international staging system iss for multiple myeloma.
Staging a can also be done according to prognosis, or expected survival. Staging provides essential information that helps guide your treatment options. International staging system for multiple myeloma the imf. Multiple myeloma prognosis riss revised international staging system for myeloma cllipi the international prognostic index for patients with chronic lymphocytic leukemia expected spleen size provides upper limit of normal for spleen length and volume by ultrasound relative to. Reviewed on january 17, 2017 for clinical relevance. Iss international staging system myeloma acronymfinder. The treatment options offered to a person greatly depend on the stage of the disease as well as age at diagnosis. References the new iss system was developed and published by greipp pr et al. Revised international staging system for multiple myeloma prognostic factor stage i stage ii stage iii iss stage i serum. The international staging system calculates the myeloma stage by measuring levels of two proteins in the blood. Both these systems categorize patients into 3 stages with increasing severity. This staging system is referred to as the international staging system, or iss. The specific gene abnormalities cytogenetics of the cancer. In general, higher levels of beta2microglobulin and lower levels of albumin are associated with a poorer prognosis.
Based on how abnormal the plasma cells look under the microscope and the levels of immunoglobulins, some patients with smoldering multiple myeloma have a high risk of progressing to active myeloma. The imwg report on the newly developed revised version of the international staging system r iss which incorporates chromosomal abnormalities to develop a more powerful staging system for stratifying myeloma patients. Developed in a large sample of patients, the revised international staging system r iss for multiple myeloma is a new riskstratification algorithm with improved prognostic power compared to the three already widely used individual prognostic indicators. Multiple myeloma international staging system iss mdcalc. Now it is designed to improve our prognostication of newly diagnosed multiple myeloma patients and. The case was regarded as stage iiib according to prognostic dude salmon staging system and stage iii according to the international staging system iss for mm 18, 19. The multiple myeloma international staging system iss prognosticates the severity of multiple myeloma. Criteria for diagnosis, staging, risk stratification and. The diagnostic and response criteria recommended are primarily derived from the international myeloma working group, with certain updates and clarifications. After a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment.
Multiple myeloma is staged using the revised international staging system riss based on 4 factors. International staging system iss and the r iss iss stage i serum b2m 3. Often the stages 1 to 3 are written as the roman numerals i, ii and iii. The international staging system uses the results of 2. The international staging system is the current standard for staging of myeloma. Generally, the higher the stage number, the larger the amount of the myeloma in the body. Complications may include amyloidosis the cause of multiple myeloma is unknown. This takes account of serum beta2microglobulin sbeta2m, serum albumin, platelet count, serum creatinine, and patient age. Revised staging system prognostic for multiple myeloma. The former staging system, introduced in 2005 6, is extremely simple and is widely used by hematologists. In one study, treating these patients with lenalidomide revlimid and dexamethasone before they developed symptoms or problems helped them live longer. New systems have emerged for diagnosis, staging and response assessment in multiple myeloma mm.
Talk to your doctor if you have questions about staging. Multiple myeloma mm, also known as plasma cell myeloma and simple myeloma, is a cancer of plasma cells, a type of white blood cell that normally produces antibodies. Prognosticates the severity of multiple myeloma based on routinely obtained lab values. Patients with either of these stages of multiple myeloma often have bone complications as a result of their disease and usually experience symptoms that require treatment. The most common staging system for mm that is based on prognostic factors is the revised international staging system r iss. Here are some questions you can ask your cancer care team to help you better understand. Revised international staging system for multiple myeloma. Revised international staging system for multiple myeloma ncbi. The two staging systems used for multiple myeloma are the revised international staging system riss, which is commonly used see table 1, and the duriesalmon staging system see table 2.
At present there are 2 staging systems which are commonly used for multiple myeloma, international staging system iss and durie and salmon system. Duriesalmon staging system intl myeloma foundation. There is also a new international staging system iss which provides reliable staging which can be used in diagnosis, clinical trials and multiple myeloma life expectancy prognosis. Stage ii or iii multiple myeloma is characterized by an intermediate or high amount of cancer in the body. The simplest measure of prognosis in mm is based on blood levels of two markers. In 20, an international group divided stages into three stages based on two criteria, the concentration of beta2microglobulin. Updated diagnostic criteria and staging system for multiple myeloma article in american society of clinical oncology educational book 36. Multiple myeloma prognosis clinical staging systems. Mulfiple myeloma staging and prognosfic navigafion tool.
Standardrisk chromosomal abnormalities ca normal ldh. As it progresses, bone pain, bleeding, frequent infections, and anemia may occur. Developed in a large sample size of 3,060 patients, the revised international staging system riss for. Myeloma academy imwg revised international staging. Revised multiple myeloma international staging system riss. Thus, riss stage iii includes one of the hr cg abnormalities or. Multiple myeloma early detection, diagnosis, and staging. The revised international staging system r iss includes variables included in the original iss serum beta2 microglobulin and serum albumin, while also including the additional prognostic information obtained from serum ldh and highrisk chromosomal abnormalities detected by interphase fluorescent in situ hybridization ifish after cd8 plasma cell purification.
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