Multiple myeloma staging according to Durie and Salmon and consequent developing of the treatment plan.
Stage I | Staging criteria are fulfilled: |
1. hemoglobin value > 100 g/l2. Serum calcium value - or 3 mmol/l3. normal bone structure or solitary bone plasmacytoma4. Low M-component production rate a) M-IgG < 50 g/l, b) M-IgA < 30 g/l, c) light chain protein in urine < 4 g/24 hours. |
|
Stage II | Neither stage I nor stage III |
Stage III | One or more of the following: |
1. Hemoglobin value < 85 g/l2. Serum calcium value > 3 mmol/l3. More than 3 lytic lesions4. High M-component production rate M-Ig: a) M-IgG value > 70 g/l, b) M-IgA value > 50 g/l, c) light chain protein in urine >12 g/24 h |
|
1. | Hemoglobin value < 120 g/l |
2. | M-IgG value > 30 g/l and/or M-IgA value > 25 g/l |
3. | Level of plasmocytes in bone marrow > 25 % |
MR imaging of the spine - positive and x-ray of the skeleton - negative classifies the patient in the higher stage defined as II (MR) or III (MR) |