MDCalc

Revised Multiple Myeloma International Staging System (R-ISS)

Prognostication tool for myeloma patients based on the genetics and other routinely used lab values in conjunction with the original ISS Staging System.

Use only in patients recently diagnosed with multiple myeloma. Do not use in patients with relapsed myeloma, smoldering myeloma or MGUS.

Serum β2 microglobulin
Serum albumin
CA by iFISH
High risk defined as: presence of del(17p) and/or translocation t(4;14) and/or translocation t(14;16)
LDH

Result:

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Advice

Many MM patients are treated through clinical trials. Physicians may consider referring patients to academic treatment centers if they are eligible and willing to receive transplantation, not only to discuss standard treatment options, but also to consider clinical trial options.

Management
  • Current staging systems provide prognostic information and are useful for stratification and data assessments/comparisons.
  • The R-ISS, though a more robust powerful prognostic tool compared to ISS, is NOT directly used to alter treatment recommendations outside of a clinical trial at this time.