Myeloma stages explained: Insight into diagnosis, prognosis, managing diagnosis, and additional resources
Multiple Myeloma is a type of blood cancer that affects plasma cells, a type of white blood cell that helps fight infections. This disease interferes with proper red blood cell production, which can lead to anemia.
Staging Multiple Myeloma
Doctors use a three-step staging system to classify the severity of multiple myeloma and whether it has spread. One such system is the Durie-Salmon System, developed in 1975. This system stages multiple myeloma based on the levels of monoclonal immunoglobulin in the blood, the number of bone lesions, and the level of hemoglobin in the blood.
The Durie-Salmon System involves: - Stage 1: Early disease, with only a small number of myeloma cells in the blood. A person with stage 1 multiple myeloma may not show symptoms. - Stage 2: Progression of the cancer, and a person may start to experience symptoms such as bone pain, loss of appetite, and fatigue. - Stage 3: The most advanced stage, and a person with stage 3 multiple myeloma will continue to experience any symptoms they had in stage 2 and may also experience new symptoms such as frequent infections, confusion, and weight loss.
Another staging system is the Revised International Staging System (RISS). This system takes into account factors such as the level of albumin in the blood, the level of beta-2-microglobulin in the blood, the amount of lactate dehydrogenase in the blood, cytogenetics, and specific gene abnormalities of cancer.
Survival Rates
According to data from the Surveillance, Epidemiology, and End Results (SEER) Program and related sources, the survival rates for multiple myeloma vary by stage as defined by the International Staging System (ISS):
- Stage I: A median survival of about 62 months (approximately 5 years). The 5-year overall survival rate for multiple myeloma in the U.S. is about 54–60% for stage I patients.
- Stage II: A median survival of around 45 months. The 5-year overall survival rate for stage II patients is lower than stage I, ranging from 40–50%.
- Stage III: A median survival of about 29 months. The 5-year overall survival rate for stage III patients is the lowest, ranging from 35–40%.
Younger patients tend to have better outcomes due to better health, eligibility for aggressive treatment like autologous stem cell transplant, and stronger immune response. Older patients face more treatment limitations and comorbidities, which reduce survival rates and complicate care.
Treatment and Management
People with smoldering multiple myeloma without symptoms usually do not require treatment. However, once symptoms occur, treatment may include chemotherapy, steroids, proteasome inhibitors, monoclonal antibodies, and stem cell transplant.
Pain management for multiple myeloma can include pain relieving medication, radiation therapy, massage, or acupuncture. A healthy lifestyle, such as not smoking, eating a well-balanced diet, getting enough sleep, and exercise, can help a person manage symptoms of myeloma and cope with side effects of treatment.
The ACA recommends that a person with multiple myeloma is monitored by medical professionals to help them cope with their illness. Careful monitoring by a healthcare professional can help identify disease progression and target the most appropriate treatment.
Related Conditions
Conditions related to multiple myeloma include Monoclonal gammopathy of undetermined significance (MGUS), plasmacytoma, and amyloidosis. These conditions can affect the prognosis and treatment of multiple myeloma.
In summary, ISS staging correlates with median survival: the lower the stage, the better the prognosis. The SEER data highlight that younger patients have higher 5-year survival rates ranging from 60–70% versus 35–40% in elderly patients. Treatment advances and personalized approaches continue to improve survival across stage and age groups.
- The Durie-Salmon System, a three-step staging method for multiple myeloma, takes into account the levels of monoclonal immunoglobulin in the blood, the number of bone lesions, and the level of hemoglobin in the blood.
- Stage I multiple myeloma, according to the International Staging System (ISS), has a median survival of about 62 months and a 5-year overall survival rate of about 54–60%.
- Some related medical conditions to multiple myeloma include Monoclonal gammopathy of undetermined significance (MGUS), plasmacytoma, and amyloidosis, which can impact the prognosis and treatment of multiple myeloma.
- A healthy lifestyle, including not smoking, eating a well-balanced diet, getting enough sleep, and exercise, can help people with multiple myeloma manage symptoms and cope with side effects of treatment.
- The Affordable Care Act (ACA) recommends that a person with multiple myeloma is monitored by medical professionals to help cope with the illness and identify disease progression for targeted treatment.
