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Figure 4: Multiple Myeloma Staging Criteria
International Myeloma Staging System
Monoclonal gammopathy of undetermined significance (MGUS)=M-protein found in blood without other diagnostic criteria for multiple
Stage I: All of the following:
- Hemoglobin >10 g/dL.
- Normal serum calcium.
- Normal bone structure.
- Low M-protein production as shown by:
- IgG <5.0 g/dL.
- IgA <3.0 g/dL.
- Urinary kappa (κ) or lambda (λ) light chains <4 g/24 hours.
- Low myeloma cell mass (<0.6 X 1012) cells/m2.
Stage I multiple myeloma:
- Beta-2-microglobulin <3.5.
- Albumin ≥3.5.
Stage II: Disease neither stage I nor stage III:
- Intermediate myeloma cell mass: 0.6 to 1.2 trillion (1012)/m2
Stage II multiple myeloma:
- Beta-2-microglobulin <3.5 and albumin <3.5, or
- Beta-2-microglobulin 3.5 to <5.5.
Stage III means 1 or more of the following:
- Hemoglobin <8.5 g/dL.
- Serum calcium >12.0 mg/dL.
- More than 3 lytic bone lesions (>75%).
- High M-protein production as shown by:
- IgG >7.0 g/dL.
- IgA >5.0 g/dL.
- Urinary kappa (κ) or lambda (λ) >12.0 g/24 hours.
- Estimated myeloma cell mass: >1.2 trillion (1012)/m2 (high burden).
Stage III multiple myeloma:
- Beta-2-microglobulin ≥5.5
Subclassified based upon renal function:
- Serum creatinine <2 mg/dL.
- Serum creatinine ≥2 mg/dL.
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