Stage A: serum creatinine <175^mol/L Stage B: serum creatinine >175^mol/L

Durie, B.G. & Salmon, S.E. (1975) A clinical staging system for multiple myeloma-Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival- Cancer, 36, 842-854.

Serum ^-microglobulin (fe-M) is most powerful prognostic factor (measure of tumour bulk) and can be used with serum C-reactive protein (CRP) a surrogate measure for serum IL-6 (measure of tumour aggression) to assess prognosis:

Low risk both p2-M <6mg/L & CRP <6mg/L median survival 54 mo

Intermed. risk either p2-M or CRP >6mg/L median survival 27 mo

High risk both p2-M >6mg/L & CRP >6mg/L median survival 6 mo

Bataille, R. et al. (1992) C-reactive protein and beta-2 microglobulin produce a simple and powerful myeloma staging system. Blood, 80, 733-737.

International Prognostic Index (IPI) has been devised using serum p2-M and serum albumin (ALB):

Stage 1

b2-M <3.5mg/L; ALB >35g/L

median survival 62 mo

Stage 2

b2-M <3.5mg/L; ALB <35g/L

median survival 41 mo

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