International Staging System for multiple myeloma
Haematology
Also known as: Revised ISS (R-ISS) · R2-ISS · ISS / R-ISS / R2-ISS (Multiples Myelom) · Multipl miyelom ISS / R-ISS evrelemesi · International Staging System (ISS), R-ISS and R2-ISS for multiple myeloma
What it is for
Prognostic staging of newly diagnosed multiple myeloma from serum β2-microglobulin (β2M), albumin, lactate dehydrogenase (LDH) and chromosomal abnormalities (CA) on interphase fluorescence in situ hybridisation (iFISH).
Classification
| Category | Description |
|---|---|
| ISS I | β2M <3.5 mg/L and albumin ≥3.5 g/dL. |
| ISS II | neither stage I nor stage III. |
| ISS III | β2M ≥5.5 mg/L (regardless of albumin). |
| R-ISS I | ISS I, no high-risk CA and normal LDH. |
| R-ISS II | all other combinations (not R-ISS I or III). |
| R-ISS III | ISS III plus high-risk CA [del(17p) and/or t(4;14) and/or t(14;16)] or LDH above the upper limit of normal. |
| R2-ISS (points) | ISS II 1; ISS III 1.5; del(17p) 1; high LDH 1; t(4;14) 1; gain or amplification of 1q 0.5. Groups: I (low) 0; II (low-intermediate) 0.5–1; III (intermediate-high) 1.5–2.5; IV (high) 3–5. |
Source
Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group
IMWG · J Clin Oncol 2015;33:2863–2869 (Palumbo A et al.)
PMID: 26240224
- Edition
- ISS 2005 (Greipp et al.), R-ISS 2015 (Palumbo et al., IMWG), R2-ISS 2022 (D'Agostino et al., European Myeloma Network)
- Checked on
Summary of the published classification in our own words. Not a substitute for the original publication.
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