What is the revised international staging system for multiple myeloma (MM)?

Updated: Mar 06, 2020
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

In the 2015 revision of the International Staging System (ISS) , stage I comprises all of the following:

  • ISS stage I  
  • Standard-risk chromosomal abnormalities by fluorescence in situ hybridization (FISH)(ie, no high-risk)
  • Serum lactate dehydrogenase (LDH) level at or below the upper limit of normal

Stage II consists of all other possible combinations of ISS criteria, chromosomal abnormalities, and LDH other than those of stage I or III.

Stage III consists of the following:

  • ISS stage III  and 
  • High-risk chromosomal abnormalities by FISH (ie, presence of del(17p) and/or translocation t(4;14) and/or translocation t(14;16))  or
  • Serum LDH level above the upper limit of normal          

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