[Proposal of a new staging system using scoring of multiple myeloma]

A new simple scoring staging system was developed and evaluated in 121 cases of multiple myeloma, followed from first diagnosis to demise. A score of 1 was assigned to each of the following features: bone marrow plasma cells more than 30%, hemoglobinemia less than 11 g/dl, lytic bone lesions of degrees 2-3, presence of Bence Jones proteinuria and serum beta 2-microglobulin levels higher than 8.0 micrograms/ml. Therefore, the score for each patient ranged from 0 to 5, corresponding to six risk classes: score 0 = class I; score 1 = class II; score 2 = class III; score 3 = class IV; score 4 = class V; score 5 = class VI. Since no differences in mean survivals and in survival curves were found between classes I and II, between classes III and IV and between classes V and VI, three stages could be devised: stage A (good prognosis) corresponding to classes I and II; stage B (intermediate prognosis) corresponding to classes III and IV; stage C (poor prognosis) corresponding to classes V and VI. Significant differences were found among the three stages regarding mean survivals, survival curves, and response to treatment. This scoring staging system is very simple in its formulation; only five routine parameters and no calculations are necessary for obtaining a score and consequently a stage for each patient. Moreover, the system can identify categories of multiple myeloma patients with homogeneous characteristics since it appears to be correlated with response to treatment and survival.