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Biopsies

TESTS YOU REALLY NEED

Staging

The International Myeloma Foundation is proud to have sponsored and coordinated the development of the International Staging System (ISS) for Multiple Myeloma in 2005. The ISS was developed through a collaborative research initiative conducted by 17 myeloma institutions around the world.  Based on that research, the factors found to best stratify patients’ prognosis into a three-stage classification were two blood proteins: serum beta 2 microglubulin and serum albumin.

In August, 2015 the International Myeloma Working Group (IMWG) published its Revised International Staging System (R-ISS), which combines the ISS with chromosomal abnormalities detected by interphase fluorescent in situ hybridization (FISH) and serum lactate dehydrogenase (LDH). Clinical data from 4,445 patients with newly diagnosed myeloma in 11 international clinical trials were pooled and analyzed to create this updated simple yet powerful prognostic staging system.   

REVISED INTERNATIONAL STAGING SYSTEM (R-ISS) FOR MYELOMA

STAGE
CRITERIA
I

Serum ß2 microglobulin < 3.5 mg/l
Serum albumin ? 3.5 g/dl
Standard-risk chromosomal abnormalities (CA)
Normal LDH

II
Not R-ISS stage I or III
III

Serum ß2 microglobulin ? 5.5 mg/L and either
High-risk CA by FISH
OR
High LDH

Related Links:

Understanding Your Test Results

Revised International Staging System for Multiple Myeloma

©2015 International Myeloma Foundation

 

Biopsies

BONE MARROW BIOPSIES

Bone marrow biopsies are performed routinely to diagnose myeloma. They are also used for periodic monitoring of myeloma during the course of treatment. Bone marrow biopsies provide information about the amount of disease, the type of disease, its aggressiveness, and molecular/genetic abnormalities that help to predict the disease course. They provide the only direct access to tumor cells for examination by a pathologist, so they are necessary even though they are invasive and can be painful. Moreover, because myeloma is patchy and is not distributed evenly throughout the bone marrow, bone marrow biopsies do not always present an accurate sample of what is occurring elsewhere in the marrow.

OTHER TISSUE BIOPSIES

Other tissue biopsies are performed less frequently to determine if myeloma is present outside the bone marrow, or in early stage disease, to biopsy a solitary plasmacytoma.

BIOPSIES
Mike Katz, IMF Board Member