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The revised staging system for myeloma combines the older albumin and beta-2 microglobulin stage with high-risk chromosome changes and a raised lactate dehydrogenase, giving three groups with very different survival.
Analysis of 3,060 patients from eleven international trials to build a staging system combining ISS stage, chromosomal abnormalities detected by fluorescence in situ hybridisation (del(17p), t(4;14), t(14;16)) and serum lactate dehydrogenase.
Five-year overall survival was 82 percent in R-ISS stage I, 62 percent in stage II and 40 percent in stage III. The R-ISS became the standard prognostic framework and the basis for trial stratification.
The stage on a myeloma report, and the label of high-risk disease that drives intensified treatment and trial choice, comes from the R-ISS; the 2022 R2-ISS adds 1q gain.
Shares Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible.
Shares Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma.
Shares Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible.
Shares Plasma cell leukaemia, Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma.
Shares Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma.
Shares Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma.
Shares Newly diagnosed multiple myeloma, transplant-eligible, Relapsed or refractory multiple myeloma.