Risk stratification
Doctors can predict which people with multiple myeloma are most likely to have the
best or worst outcome based on the number of changes in the chromosomes. This is
called risk stratification. Risk stratification can also be used to make treatment
decisions. Risk stratification is calculated when you are first diagnosed and may be
repeated if there is a
Risk stratification can be calculated using the Revised International Staging System as well as the Mayo Stratification for Myeloma and Risk-Adapted Therapy (mSMART).
Standard-risk multiple myeloma is when the myeloma cells have any of the following changes in the chromosomes:
-
trisomy -
translocation of chromosomes 11 and 14, which is also called t(11;14) - translocation of chromosomes 6 and 14, which is also called t(6;14)
High-risk multiple myeloma is when the myeloma cells have any of the following changes in the chromosomes:
- translocation of chromosomes 4 and 14, which is also called t(4;14)
- translocation of chromosomes 14 and 16, which is also called t(14;16)
- translocation of chromosomes 14 and 20, which is also called t(14;20)
- an extra copy of the long arm "q" of chromosome 1, which is also called gain(1q)
- a missing short arm "p" of chromosome 1, which is also called 1p deletion or del(1p)
- a missing short arm "p" of chromosome 17, which is also called 17p deletion or del(17p)
- fewer chromosomes than normal, which is also called hypodiploidy
If the myeloma cells have 2 high-risk chromosome changes, this is sometimes called double-hit myeloma.
If the myeloma cells have 3 high-risk chromosome changes, this is sometimes called triple-hit myeloma.
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