Multiple Myeloma Treatment

The efficiency of multiple myeloma treatment depends on how advanced the cancer is at the time of diagnosis. Multiple myeloma stages are classified according to a number of criteria. Classification of cancer stages indicates which treatments are the most appropriate for the individual patient.

The Durie-Salmon Staging Classification System

Multiple myeloma is staged according to the Durie-Salmon classification system. The Durie-Salmon system has three stages. The higher the classification number, the more advanced the cancer:

  • Stage I: Testing reveals a low M component, with no sign of anemia or hypercalcemia. X-rays reveal no bone lesions, or only a single lesion.
  • Stage II: An intermediate condition, Stage II is more advanced than I, but lacks the characteristics of III.
  • Stage III: MM is classified as Stage III if one or more of the following criteria are also present: anemia, hypercalcemia, multiple bone lesions, or high M component.

Creatinine Levels and Durie-Salmon

Average Survival Rates by Stage

Stage IA: 61 months

Stage IIA/IIB: 55 months

Stage IIIA: 30 months

Stage IIIB: 15 months.

The Durie-Salmon classification system is sometimes criticized as being too vague: most multiple myeloma cases fall into Stage III when this system is used. Combining Durie-Salmon with creatinine levels provides a more accurate picture of the disease. Creatinine is a blood borne protein usually filtered out of the body by the kidneys.

Multiple myeloma creatinine levels in the blood are classified as “A” or “B” with a “B” result indicating a poorer prognosis than “A.” B indicates high creatinine levels and failing kidney function. Creatinine level results are combined with the Durie-Salmon system. A Stage IA case of multiple myeloma would indicate no anemia, hypercalcemia or other symptoms, combined with low creatinine levels.

Beta-2-Microglobulin Levels

The level of beta-2-microglobulin in the blood may further influence the prognosis of multiple myeloma. Beta-2-microglobulin is a protein produced by myeloma cells. High levels of the protein indicate that cancer cells are present in large numbers.

Multiple Myeloma Treatment

Without treatment, the average survival time for multiple myeloma is only eighteen months. Younger patients are more likely to respond to aggressive treatment, which may improve survival by as much as four to six years.

At present, the most effective treatment for MM is a combination of high dose chemotherapy (HDT) in combination with autologous bone marrow stem cell transplantation (the stem cells come from the patient).