The Cardiovascular
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Revised Multiple Myeloma International Staging System (R-ISS)

Myeloma staging combining ISS, FISH cytogenetics, and LDH.

Revised Multiple Myeloma International Staging System (R-ISS)
Serum beta-2-microglobulin
mg/L
Serum albumin
g/dL
High-risk FISH (del(17p), t(4;14), and/or t(14;16))
Elevated LDH (above upper limit of normal)
Complete the fields above to see the result.

When to use

  • Prognostic staging of newly diagnosed multiple myeloma incorporating cytogenetic and LDH risk on top of ISS.

Formula

ISS I: b2-microglobulin <3.5 mg/L and albumin >=3.5 g/dL. ISS III: b2-microglobulin >=5.5 mg/L. ISS II: neither. R-ISS I = ISS I + standard-risk cytogenetics + normal LDH. R-ISS III = ISS III + (high-risk cytogenetics or elevated LDH). R-ISS II = all other combinations.

References

  1. Palumbo A, et al. J Clin Oncol. 2015;33(26):2863-2869.