The staging system for myeloma developed by Alexanian et al. is related to that of Durie and Salmon.


Low tumor mass assumed if all 4 of the following are present:

(1) hemoglobin > 10.5 g/dL

(2) corrected serum calcium level <= 11.5 mg/dL, using the correction for serum albumin (Payne, 1973)

(3) low serum myeloma protein (IgG < 5 g/dL; IgA < 3 g/dL)

(4) must not have extensive bone lesions


Intermediate tumor mass

(1) not low tumor mass AND not high tumor mass


High tumor mass assumed if any 1 of the following are present:

(1) hemoglobin < 8.5 g/dL

(2) corrected serum calcium > 11.5 g/dL

(3) increased serum myeloma protein (IgG > 7 g/dL; IgA > 5 g/dL)



• Conversion of calcium from mg/dL to mmol/L is 0.25; from mmol/L to mg/dL is 4.0.

• For patients with only Bence-Jones proteinuria, then decision based classification on hemoglobin, corrected calcium level and extent of bony lesions.


corrected total serum calcium if normal albumin =

= (current total serum calcium) + (4 - (current albumin in g/dL)) mg/dL



• A low tumor mass associated with good prognosis and long remission periods.

• A high tumor mass associated with poor prognosis, often due to short remission after treatment.


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