Risk factors and stratification models in patients with multiple myeloma
| ISS59 . | R-ISS17 . | R2-ISS18 . | Other risk factors . |
|---|---|---|---|
| Stage I: serum β2M < 3.5 µg/L and serum albumin ≥3.5 g/dL Stage II: not ISS stage I or III Stage III: serum β2M ≥ 5.5 µg/L | Stage I: ISS stage I, t(4;14), and/or t(14;16) and/or del(17p) negativity by FISH and normal serum LDH Stage II: not ISS stage I or III Stage III: ISS stage III and either elevated serum LDH or t(4;14) and/or t(14;16) and/or del(17p) positivity by FISH | Additive score: ISS II: 1 point ISS III: 1.5 points Del(17p): 1 point Elevated serum LDH: 1 point t(4;14): 1 point 1q+: 0.5 point Groups: Low risk: 0 Low intermediate: 0.5-1 Intermediate-high: 1.5-2.5 High: 3-5 | Genetic lesions: deletion and mutations of TP535 ; deletion chromosome 1p detected by FISH4 Extramedullary disease60 CTCs detected in the peripheral blood by flow cytometry14,15 Plasma cell leukemia and plasma cell leukemia–like disease16,61 GEP: high-risk signatures9-12 |
| ISS59 . | R-ISS17 . | R2-ISS18 . | Other risk factors . |
|---|---|---|---|
| Stage I: serum β2M < 3.5 µg/L and serum albumin ≥3.5 g/dL Stage II: not ISS stage I or III Stage III: serum β2M ≥ 5.5 µg/L | Stage I: ISS stage I, t(4;14), and/or t(14;16) and/or del(17p) negativity by FISH and normal serum LDH Stage II: not ISS stage I or III Stage III: ISS stage III and either elevated serum LDH or t(4;14) and/or t(14;16) and/or del(17p) positivity by FISH | Additive score: ISS II: 1 point ISS III: 1.5 points Del(17p): 1 point Elevated serum LDH: 1 point t(4;14): 1 point 1q+: 0.5 point Groups: Low risk: 0 Low intermediate: 0.5-1 Intermediate-high: 1.5-2.5 High: 3-5 | Genetic lesions: deletion and mutations of TP535 ; deletion chromosome 1p detected by FISH4 Extramedullary disease60 CTCs detected in the peripheral blood by flow cytometry14,15 Plasma cell leukemia and plasma cell leukemia–like disease16,61 GEP: high-risk signatures9-12 |