Multiple Myeloma Program

Types and Stages

TYPES

There are different forms of myeloma-related conditions. Some require treatment and some do not. All myeloma conditions require regular check-ups to monitor whether the disease is progressing.

  • Monoclonal gammopathy of undetermined significance (MGUS)
    People who have MGUS have a small number of myeloma cells in the bone marrow, but these cells are not forming a tumor and symptoms of myeloma are not present. This condition is usually discovered during a routine blood exam that shows unusual levels of protein in the blood.
  • MGUS is a pre-cancerous condition. Therefore, check-ups should occur every 6 months to monitor the condition and make sure that it does not develop into MM. MGUS develops into MM in only a small number of patients.
  • A diagnosis of MGUS should not be made without a chromosome analysis, gene array, MRI, and/or a PET/CT scan.
  • Asymptomatic (Smoldering/Indolent) Myeloma
    Asymptomatic myeloma falls somewhere between MGUS and symptomatic multiple myeloma. In this condition, a person has a greater number of myeloma cells than a person with MGUS. However, the disease does not cause any damage to the body and the typical myeloma symptoms [link to http://www.huntsmancancer.org/patient-care/clinics-and-programs/multiple-myeloma-program/symptoms] are not present, though patients may exhibit anemia due to causes other than myeloma.
  • Asymptomatic myeloma can be stable for many months or years, but it ultimately tends to progress. The patient will likely need treatment at some point. He or she will need to be monitored to see if the disease progresses and if symptoms appear.
  • Symptomatic (Active) Myeloma
    This type of myeloma represents overt cancer. A person with symptomatic myeloma has more myeloma cells than a person with asymptomatic myeloma or MGUS.
  • At this point, the disease is causing the body damage, such as bone damage, anemia, kidney problems, or hypercalcemia (high levels of calcium in the blood).

STAGES

Staging is the process of finding out the extent of a person's myeloma. There are two staging systems that myeloma doctors consult:

  • Durie-Salmon staging
    In this system, there are three stages of myeloma: Stage I, Stage II, and Stage III. The stage depends on certain factors:
    • The amount of myeloma cells in the body
    • The amount of damage the myeloma cells have caused to the bone
    • Levels of M-protein in the blood or urine
    • Blood calcium levels
    • Albumin and hemoglobin levels
  • Myeloma can also be further classified into Group A or Group B, based on damage to the kidneys. Group A indicates normal kidney function. Group B indicates abnormal kidney function. A person could be classified as Stage IIB, for example.
  • International Staging System (ISS)
    This staging system is based on the albumin level (more or less than 3.5 mg/dL) and B2-microglobulin level (< 3.5; 3.5-5 or > 5 mg/L). The lower the stage, the better the outcome. This staging system is based on outcomes of more than 10,000 cancer cases.

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