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In 1975, the Durie-Salmon Staging System was developed, bringing together the major clinical parameters in correlation with measured myeloma cell mass (the total number of myeloma cells in the body). The Durie-Salmon Staging System demonstrates the correlation between the amount of myeloma and the damage it has caused, such as bone disease or anemia. The following table details the stages and criteria for measuring the presence and staging of multiple myeloma.

Stage Criteria Measured Myeloma Cell Mass (myeloma cells in billions/m2)*
Stage 1

 

(low cell mass)

All of the following:

  • Hemoglobin value > 10 g/dl
  • Serum calcium value normal or <10.5 mg/dL
  • Bone X-ray, normal bone structure (scale 0), or solitary bone plasmactyoma only
  • Low M-component production rates IgG value < 5g/dL; IgA value < 3 g/dL
  • Urine light chain M-component on electrophoresis < 4 g/24h
   600 billion*
Stage II

 

(intermediate
cell mass)		 Fitting neither
Stage I nor Stage III		   600 to 1,200 billion*
Stage III

 

(high cell mass)		 One or more of the following:
 
  • Hemoglobin value < 8.5 g/dL
  • Serum calcium value > 12 mg/dL
  • Advanced lytic bone lesions (scale 3)
  • High M-component production rates IgG value > 7 g/dL; IgA value > 5 g/dL
  • Urine light chain M-component > 12 g/24h
   >1,200 billion*
Subclassification
(either A or B)
 
  • A: relatively normal renal function (serum creatinine value) < 2.0 mg/dL
  • B: abnormal renal function (serum creatinine value) > 2.0 mg/dL
Examples:
Stage 1A (low cell mass with normal renal function);
Stage IIB (high cell mass with abnormal renal function)		  

 

What's Next?

What Are the Most Up-To-Date Systems Used to Stage Myeloma?

Learn more about the International Staging System (ISS) and the Revised International Staging System (R-ISS).

 


The International Myeloma Foundation medical and editorial content team

Comprised of leading medical researchers, hematologists, oncologists, oncology-certified nurses, medical editors, and medical journalists, our team has extensive knowledge of the multiple myeloma treatment and care landscape. 

Additionally, the content on this page is medically reviewed by myeloma physicians and healthcare professionals.

Last Medical Content Review: July 20, 2021

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