Revised International Staging System (R-ISS) for myeloma
Myeloma stage from ISS, LDH, and high-risk cytogenetics.
Inputs
0 of 2mg/L
LDH above the upper limit of normal
High-risk cytogenetics: del(17p), t(4;14), or t(14;16)
When to use
- Newly diagnosed multiple myeloma.
Pearls and pitfalls
- High-risk cytogenetics: del(17p), t(4;14), or t(14;16) by FISH.
- 5-year overall survival: 82% (I), 62% (II), 40% (III) in the derivation cohort.
Why use
Adds biology to ISS.
Stage I: ISS I, normal LDH, standard-risk cytogenetics. Stage III: ISS III with high LDH or high-risk cytogenetics. Stage II: all others.