International Staging System (ISS) for Symptomatic Myeloma
Prognostic score for newly-diagnosed symptomatic myeloma
|ISS stage1||Criteria||Five year OS2|
|I||β2-microglobulin < 3.5 mg/L (< 296 nmol/L) AND albumin ≥ 35 g/L||66|
|II||Not meeting criteria for stage I or III||45|
|III||β2-microglobulin > 5.5 mg/L||18|
The International Staging System (ISS) derives from multivariate analysis of survival of > 10,000 patients with newly-diagnosed symptomatic myeloma.1 Initial treatment was administered between 1981 and 2002, and included autologous stem cell transplantation in a quarter of patients.
The ISS stage retains prognostic relevance in the era of novel agents (thalidomide, bortezomib, lenalidomide): Five year overall survival among patients who received first line therapy including novel agents was 66%, 45% and 18% for ISS stage I, II and III patients, respectively.2
- Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Bladé J et al. International staging system for multiple myeloma. J Clin Oncol 2005; 23: 3412-3420.
- Kastritis E, Zervas K, Symeonidis A, Terpos E, Delimbassi S, Anagnostopoulos N et al. Improved survival of patients with multiple myeloma after the introduction of novel agents and the applicability of the International Staging System (ISS): an analysis of the Greek Myeloma Study Group (GMSG). Leukemia 2009; 23: 1152-1157.