Prognostic Value of the Staging System Proposed by Merlini, Waldenström and Jayakar for Multiple Myeloma

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Abstract
We have reviewed a series of 90 consecutive patients with multiple myeloma (MM) diagnosed in the period 1.1.1971–31.12.1980 and subsequently treated with an intermittent administration of melphalan and prednisone (62 IgG MM, 20 IgA MM and 8 Bence-Jones (BJ) MM). Unfavorable prognostic factors were: presence of micro-molecular M component (K or λ), serum creatinine ≥2 mg/dl, serum calcium ≥ 12 mg/ dl, presence of BJ proteinuria, Hb < 10 g/dl, diffuse osteolytic lesions, bone marrow plasma cell percentage ≥ 30%. In particular, according to the recent staging system proposed by Merlini et al. [Blood 55: 1011, 1980], the most important prognostic parameters for IgG and BJ MM were: serum creatinine, BMPC % and serum calcium; for IgA MM the most important were: serum hemoglobin, calcium and M component levels. We have compared the survival curve of 45 patients who died, with the predicted survival curve according to the multivariate regression analysis of Merlini and co-workers; the prediction was equally precise for all the three types of MM considered, thus showing the high sensibility of this new staging system.

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