[Prognostic value of the new international staging system in multiple myeloma. Comparison with Durie-Salmon staging
Guillermo Conté L1, Gastón Figueroa M, Vivianne Lois V
1Sección de Hematología, Hospital Clínico, Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile. gfconte@gmail.com
Background:
Since 1975, the Durie-Salmon staging system (D&S) has been a widely accepted prognostic classification of multiple myeloma (MM) patients. Recently, the new International Staging System (ISS) was developed using only the values of albumin and beta2-microglobulin.
Aim:
To compare survival of patients with MM treated in six medical centers in Chile according to the D&S system and the new ISS.
Material And Methods:
Retrospective analysis of demographic information, clinical features and survival rate of patients treated between 1998 and 2002, and grouped according to both systems.
Results:
Information of 81 patients aged 38 to 90 years (43 women) was retrieved. According D&S system 11% were in stage I 12% in stage II and 73% in stage III According to ISS, 34% were in stage I 35% in stage II and 31% in stage III Median of survival of all patients was 32 months. Both staging systems had a prognostic value. However, median survival for the three stages of the ISS system was significantly different (67, 29 and 14 months in stages III and III, respectively, p =0.02). Patients in advanced stages II and III of the ISS, had a higher frequency of anemia, hypercalcemia, renal failure and hypoalbuminemia. In stages II and III of ISS the presence of renal failure was associated with a non significantly different lower survival.
Conclusions:
The ISS is a simple and effective grouping method for patients with MM, that predicts survival. The presence of renal insufficiency might identify a subgroup of patients included in stages II and III of ISS with a higher mortality.
