The International Staging System (ISS) for myeloma uses the results of these 2 blood tests to help find out the stage of myeloma:
- beta-2 microglobulin (B2M)
- albumin level.
If B2M is raised or if albumin is lower than normal, these can be signs the myeloma is more advanced.
There are 3 stages of myeloma. Stage 1 is the earliest stage and stage 3 is more advanced.
|B2M (measured in mg/L)||Albumin (measured in g/dL)|
|Stage 1 myeloma||Normal or near normal (less than 3.5)||Normal (3.5 or more)|
|Normal or near normal (less than 3.5)||Low (less than 3.5)|
|Stage 2 myeloma||OR|
|Raised (3.5 to 5.5)||Any level|
|Stage 3 myeloma||High (5.5 or more)||Any level|
Sometimes doctors use an adapted version of the ISS. This is called the Revised International Staging System (R-ISS). This uses:
- the results of the blood tests from the ISS
- a blood test called lactate dehydrogenase (LDH)
- the results of a cytogenetic test (called FISH) on the chromosomes of the myeloma cells.
Doctors also look at the effect myeloma is having on your body.
They may use the results of tests called the CRAB criteria to assess this:
- C – Calcium levels are raised.
- R – Renal (kidney) problems.
- A – Anaemia (low number of red blood cells).
- B – Bone damage.
They will ask if you have had repeated infections or symptoms linked to thickening of the blood (hyperviscosity). We have more about symptoms of hyperviscosity in our information about managing symptoms and complications of myeloma.