Staging systems for multiple myeloma: a comparison

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Abstract
In 152 patients with multiple myeloma who were treated with cytostatic agents the prognostic value of 7 staging systems was evaluated: Carbone et al; Acute Leukemia Group B (ALGB) and Eastern Cooperative Oncology Group (ECOG) Costa et al; Southeastern Cancer Study Group (SECG-SG); Durie and SAlmon; Alexanian et al; Merlini et al; British Medical Research Council. The staging systems of the ALGB (Costa et al and SECSG), both dividing patients into good risk and poor risk groups, showed significantly different survival curves. Despite statistical significance the observed differences were rather small. In the systems of Carbone et al, Merlini et al, Alexanian et al and Durie and Salmon, some of the differences in the survival curves were statistically significant while others were not. Data best fitted into the British Medical Research Council staging system, the survival curves of all 3 stages showing significant differences, with median survival time dropping from 83 mo. in stage A to 52 mo. in stage B and 26 mo. in stage C. None of those systems was clearly superior to single risk factors, especially creatinine and Hb.