Stages of multiple myeloma
Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Cancers that form solid tumours are given numbered stages based on the size of the tumour and if the cancer has spread to lymph nodes or other parts of the body.
Multiple myeloma is not staged in the same way as other types of cancer. Multiple myeloma is a cancer of the plasma cells. Plasma cells are a type of white blood cell that makes antibodies (also called immunoglobulins) to help the body fight infection. Blood cells, including plasma cells, are formed in the bone marrow throughout the body.
To determine the stage of multiple myeloma, the healthcare team will do blood chemistry tests and cytogenetic tests. They will look for:
-
the level of a protein in
plasma ( called albumin) -
the level of a protein on the surface of myeloma cells that is involved in the
immune response ( called beta-2-microglobulin) -
the level of
lactate dehydrogenase in the blood - high-risk chromosome changes, such as a missing part of chromosome 17 (called a 17p deletion), a rearranged chromosome 4 (called a translocation) or a rearranged chromosome 14
Knowing the stage helps your healthcare team understand how multiple myeloma will likely affect your body, plan what treatments should start right away and estimate the outcome (prognosis).
Revised International Staging System
The staging system most often used in Canada for multiple myeloma is the Revised International Staging System. It has 3 stages – stage 1, stage 2 and stage 3. Often the stages are written as the Roman numerals I, II and III. Generally, the higher the stage number, the more advanced the cancer.
Find out more about staging cancer.
Stage 1
The albumin level is 3.5 g/dL or more.
The beta-2-microglobulin level is less than 3.5 mg/L.
There are no high-risk chromosome changes.
The lactate dehydrogenase level is normal.
Stage 2
The lab test results do not fit the criteria for stage 1 or stage 3.
Stage 3
The beta-2-microglobulin level is greater than 5.5 mg/L.
There are high-risk chromosome changes or the lactate dehydrogenase level is elevated.
Relapsed multiple myeloma
Relapsed multiple myeloma means that the cancer has come back after it has been treated.
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