Multiple Myeloma staging: International Staging System (ISS) and the R-ISS
| ISS stage | |
| I | Serum b2M < 3.5 mg/L, serum albumin >/=3.5 g/dL |
| II | Not ISS stage I or III |
| III | Serum b2M >/= 5.5 mg/L |
| CA by iFISH | |
| High risk | Presence of del(17p) and/or translocation t(4;14) and/or translocation t(14;16) |
| Standard risk | No high-risk CA |
| LDH | |
| Normal | Serum LDH < the upper limit of normal |
| High | Serum LDH > the upper limit of normal |
| R-ISS stage | R-ISS stage is based on ISS stage + FISH findings+ LDH |
| I | ISS stage I and standard-risk CA by iFISH and normal LDH |
| II | Not R-ISS stage I or III |
| III | ISS stage III and either high-risk CA by iFISH or high LDH |
References:
- Greipp PR, San Miguel J, Durie BG et al. International staging system for multiple myeloma. J Clin Oncol 2005; 23: 3412–3420
- Palumbo A, Avet-Loiseau H, Oliva S et al. Revised international stagingbsystem for multiple myeloma: a report from International Myeloma Working Group. J Clin Oncol 2015; 33: 2863–2869.