R-ISS_calculator v.1
Revised multiple myeloma international staging system (R-ISS) is a prognostication tool for myeloma patients based on the genetics and other routinely used lab values in conjunction with the original ISS Staging System.
To provide better discrimination of prognosis for MM based on the genetics and other routinely used lab values in conjunction with the original ISS staging system.
Use only in patients recently diagnosed with multiple myeloma. Formula: 1. Assign ISS stage: Serum albumin, g/dL ≥3.5 <3.5 Serum β2 microglobulin, mg/L <3.5 ISS I ISS II 3.5-5.4 ISS II ISS II ≥5.5 ISS III ISS III 2. Stage R-ISS according to iFISH and LDH: High-risk cytogenetic abnormalities by iFISH* LDH No Yes Normal/High ISS I R-ISS I R-ISS II Normal R-ISS II R-ISS II High ISS II R-ISS II R-ISS II Normal R-ISS II R-ISS II High ISS III R-ISS II R-ISS III Normal R-ISS III R-ISS III High *High-risk = presence of del(17p) and/or translocation t(4;14) and/or translocation t(14;16). R-ISS interpretation: R-ISS Stage Median progression-free survival I 66 months II 42 months III 29 months
Not to be used in patients with relapsed myeloma, smoldering myeloma or MGUS.
1. Palumbo A, Avet-Loiseau H, Oliva S, Lokhorst HM, Goldschmidt H, Rosinol L, Richardson P, Caltagirone S, Lahuerta JJ, Facon T, Bringhen S, Gay F, Attal M, Passera R, Spencer A, Offidani M, Kumar S, Musto P, Lonial S, Petrucci MT, Orlowski RZ, Zamagni E, Morgan G, Dimopoulos MA, Durie BG, Anderson KC, Sonneveld P, San Miguel J, Cavo M, Rajkumar SV, Moreau P. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015 Sep 10;33(26):2863-9. doi: 10.1200/JCO.2015.61.2267. Epub 2015 Aug 3. PMID: 26240224; PMCID: PMC4846284. 2. Greipp PR, San Miguel J, Durie BG, Crowley JJ, Barlogie B, Bladé J, Boccadoro M, Child JA, Avet-Loiseau H, Kyle RA, Lahuerta JJ, Ludwig H, Morgan G, Powles R, Shimizu K, Shustik C, Sonneveld P, Tosi P, Turesson I, Westin J. International staging system for multiple myeloma. J Clin Oncol. 2005 May 20;23(15):3412-20. doi: 10.1200/JCO.2005.04.242. Epub 2005 Apr 4. Erratum in: J Clin Oncol. 2005 Sep 1;23(25):6281. Harousseau, Jean-Luc [corrected to Avet-Loiseau, Herve]. PMID: 15809451.
OBSERVATION.iss-revised.v0, EVALUATION.r_iss_assessment.v0
