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Myeloma Staging System with MRI

Purpose: To stage a patient with multiple myeloma using the Durie Salmon system plus MRI imaging studies.

Description

Baur et al modified the Durie and Salmon Staging System for Multiple Myeloma by adding the findings of magnetic resonance imaging (MRI). This provides a useful prognostic tool for patients with multiple myeloma and can help identify patients who may require more aggressive therapy. The authors are from the University of Munich-Grosshadern in Munich, Germany.


 

Findings

Stage

all of the following:

(1) hemoglobin > 10 g/dL

(2) serum calcium <= 12 mg/dL

(3) monoclonal IgG < 5 g/dL

(4) monoclonal IgA < 3 g/dL

(5) Bence-Jones protein < 4 grams per 24 hours

(6) X-ray normal OR solitary bone plasmacytoma

(7) MRI no focal lesions in spine AND no diffuse infiltration

I

not Stage I or Stage III

(1) hemoglobin 8.5 - 10 g/dL

(2) monoclonal IgG 5 - 12 g/dL

(3) monoclonal IgA 3 - 5 g/dL

(4) Bence-Jones protein 4-12 grams per 24 hours

(5) X-ray 2+ lytic lesions but not extensive

(6) MRI 1-10 lesions in spine OR mild diffuse infiltration

II

one or more of the following:

(1) hemoglobin < 8.5 g/dL

(2) serum calcium > 12 mg/dL

(3) monoclonal IgG > 7 g/dL

(4) monoclonal IgA > 5 g/dL

(5) Bence-Jones protein > 12 grams per 24 hours

(6) X-ray advanced lytic lesions

(7) MRI > 10 lesions in spine OR marked diffuse infiltration

III

 

where:

• Diffuse infiltration in MRI causes decreased signal intensity with a signal intensity similar to an intervertebral disc.

 

Stage

Median Survival

I

NA (no deaths in 6 years)

II

59 months

III

15 months

 


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Specialty

ICD-10