Staging myeloma

Knowing the stage of the myeloma helps your doctors plan the best treatment for you. Generally, myeloma is divided into three stages. These show the effect the disease is having on your body and how quickly or slowly it may develop.

A commonly used staging system for myeloma is the International Staging System (ISS). The two main tests for ISS look at the levels of the blood proteins beta-2 microglobulin and albumin. The ISS stages for myeloma are:

  • Stage 1 – This is early-stage myeloma. The beta-2 microglobulin level is less than 3.5mg/L and the albumin level is 3.5g/dL or higher.
  • Stage 2 – This is intermediate-stage myeloma. The beta-2 microglobulin level is between 3.5–5.5 mg/L (with any albumin level) OR the albumin is below 3.5g/dL and the beta-2 microglobulin is less than 3.5mg/L.
  • Stage 3 – This is advanced myeloma. The beta-2 microglobulin level is 5.5mg/L or more.

The doctors will also look at the effect the 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.

The doctors will also ask whether you have been having repeated infections or symptoms related to thickening of the blood (hyperviscosity).

The results of these and other tests will allow the doctors to plan the best treatment for you.

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Treatment overview

Treatment can be used to stop myeloma developing further, to control symptoms and to improve quality of life.