Clinical Staging in Multiple Myeloma

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Abstract
Analysis of 237 patients with myeloma, retrospectively classified according to the staging system proposed by Durie and Salmon, showed highly significant differences (P < 0.0001) in the survival of patients with low, intermediate and high tumor cell masses (Stages I, II and III, respectively). The median survival for Stage I patients was 64 mo., Stage II 32 mo., and Stage III 6 mo. The median survival of patients presenting with renal impairment was only 2 mo., compared to 21 mo. for those presenting with normal renal function (P < 0.0001). The use of this clinical staging system, which is based on myeloma protein synthesis rates and the calculation of total body tumor cell mass, should be considered in planning future trials of therapy in this disease.