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Health Line
20 hours ago
- Health
- Health Line
Understanding the Stages of Multiple Myeloma
Key takeaways Multiple myeloma is a cancer of the blood that affects plasma cells, and its progression is determined using the Durie-Salmon Staging System or the Revised International Staging System (RISS). The stages of multiple myeloma range from 0 to 3, with higher stages indicating that the cancer has spread and will likely require more intensive treatment. Treatments for multiple myeloma include drug therapies, radiation, and stem cell transplants. Multiple myeloma is a blood cancer that forms in the white blood cells produced by bone marrow. Doctors stage multiple myeloma based on the levels of proteins produced by cancerous cells found throughout the body and other clinical factors affected by cancer. A higher stage means that the cancer has progressed and spread (metastasized). Typically, a higher stage, like stage 3, also causes more symptoms and requires more aggressive treatment. What is multiple myeloma? Multiple myeloma is a type of blood cancer that forms in plasma cells. Plasma cells are a type of white blood cell. Healthy plasma cells are an important part of the immune system and help the body fight infections. When multiple myeloma develops, cancerous plasma cells form. These plasma cells don't help your body fight infection. Over time, these cells multiply and overwhelm your healthy plasma cells. How is multiple myeloma diagnosed and staged? Tests such as bloodwork can help detect multiple myeloma. Blood tests can show the presence of proteins made by cancerous plasma cells. If your doctor suspects multiple myeloma, you might also be asked to do a bone marrow biopsy since plasma cells are produced in your bone marrow. Sometimes, imaging tests such as X-rays or MRIs are done to look for bone damage and other signs of multiple myeloma. Multiple myeloma is staged using the Durie-Salmon Staging System or the Revised International Staging System (RISS). Durie-Salmon Stage System stages of multiple myeloma The Durie-Salmon Stage System assigns stages by looking at: level of kidney function level of blood calcium hemoglobin concentration amount of M protein in blood and urine presence of bone lesions in imaging studies Stage Criteria I • hemoglobin level > 10 g/dL • serum calcium level < 10.5 mg/dL • a normal bone structure or solitary bone plasmacytoma assessed with conventional radiography • low rate of M-component production (IgG level < 5 g/dL; IgA level < 3 g/dL • Bence Jones protein level < 4 g/24 h II Neither stage I nor stage III III One or more of the following: • hemoglobin value < 8.5 mg/dL • serum calcium level > 12.5 mg/dL • advanced lytic bone lesions assessed with conventional radiography • high M-component production rate (IgG value > 7g/dL; IgA value > 5 g/dL; Bence Jones protein > 12 g/24 h) RISS stages of multiple myeloma The RISS assigns stages by looking at: amount of albumin in blood amount of LDH in blood amount of beta-2 microglobulin in blood gene abnormalities of multiple myeloma Below we break down the RISS stages for multiple myeloma and their treatments: Stage 0 multiple myeloma Stage 0 is sometimes called smoldering multiple myeloma or asymptomatic multiple myeloma. At this stage, there are often no symptoms. Clinical criteria for Stage 0 include: blood counts, calcium levels, and kidney function are all normal no bone or organ damage no evidence of amyloid protein buildup serum monoclonal protein greater than or equal to 30 g/L, urinary monoclonal protein greater than or equal to 500 mg per 24 hours, or clonal bone marrow plasma cells 10–60% Stage 0 multiple myeloma treatment Treatment isn't typically needed at this stage. Instead, careful monitoring and regular testing are used to watch for progression. Stage 1 multiple myeloma Multiple myeloma needs to meet certain criteria. This includes: albumin levels greater or equal to 3.5 g/dL serum beta-2 microglobulin less than 3.5 mg/L cytogenetics that are not classed 'high risk' normal LDH levels You might notice symptoms such as bone pain and weakness in your arms and legs at this stage. Stage 1 multiple myeloma treatment Drug therapies are the primary treatment for multiple myeloma. These therapies aim at destroying multiple myeloma cells and include options such as: proteasome inhibitors chemotherapy steroids antibodies immunomodulatory drugs (IMiDs) b-cell maturation antigen (BCMA)-targeted therapies A treatment plan for stage 1 multiple myeloma might include one or a combination of these drug therapies. You might also have treatments such as radiation therapy or a stem cell transplant, depending on your individual treatment plan. Stage 2 multiple myeloma Stage 2 multiple myeloma needs to meet certain criteria. This includes: beta-2 microglobulin between 3.5 mg/L and 5.5 mg/L cytogenetics are either not high risk or have a risk level that is undefined it's not stage 1 or stage 3 By stage 2, symptoms might be more advanced, including loss of appetite or stomach pain. Stage 2 multiple myeloma treatment Treatment options in stage 2 are the same as the treatment options in stage 1. Drug therapies can be used alone or in combination with options such as radiation therapy or a stem cell transplant. In stage 2, higher doses or more potent drugs might be used. Stage 3 multiple myeloma Stage 3 is the most advanced stage of multiple myeloma. To be classed stage 3, multiple myeloma needs to meet these criteria: cytogenetics are considered high risk serum beta-2 microglobulin equal or greater to 5.5 mg/L high levels of LDH Stage 3 multiple myeloma treatment Treatment by stage 3 is more aggressive to slow and stop the cancer from spreading further. Additional treatments with drug therapies are typically still part of treatment plans. A stem cell transplant might also be an option. You and your team can discuss if this is an option for you. RISS stages for multiple myeloma Bottom line Multiple myeloma is a blood cancer that affects plasma cells. Doctors use certain staging systems to discuss how far multiple myeloma has spread. As multiple myeloma advances, stages increase from 1 to 3. Often, later stages require more aggressive treatment.


India.com
24-05-2025
- Politics
- India.com
Nehru, Vajpayee, PM Modi All Attempted To Bring Permanent Peace...: DMKs Kanimozhi
All-Party Delegation: Leading the All-Party Delegation to Russia, Dravida Munnetra Kazhagam (DMK) MP Kanimozhi on Saturday said that from the first Prime Minister of India, Pandit Jawaharlal Nehru, to former PM Atal Bihari Vajpayee, to PM Narendra Modi, all have made attempts to bring 'permanent peace' between India and the neighbouring Pakistan. Addressing a briefing in Moscow, talking about terrorism, Kanimozhi of DMK also added that it is time that we do not accept any excuse and call a spade a spade. "From Pandit Jawahar Lal Nehru to Atal Bihari Vajpayee to PM Narendra Modi, they all made attempts to bring permanent peace between India and Pakistan. We have always taken the lead, but unfortunately, when peace talks are going on, we have also been hurt because of terrorist attacks in different parts of India, and the link always traces back to Pakistan, every time. Finally, it's time that we will not accept any excuse and call a spade a spade. Prime Minister said it clearly that terrorism and sponsoring terrorism are not two different things," Kanimozhi said. #WATCH | Moscow, Russia | DMK MP Kanimozhi says, "...From Pandit Jawahar Lal Nehru to Atal Bihari Vajpayee to PM Narendra Modi, they all made attempts to bring permanent peace between India and Pakistan. We have always taken the lead, but unfortunately, when peace talks are going… — ANI (@ANI) May 24, 2025 The Kanimozhi-led All-Party delegation also includes MPs Rajeev Rai (SP), Capt. Brijesh Chowta (BJP), Prem Chand Gupta (RJD), Ashok Kumar Mittal (AAP), and former Ambassador Manjeev S Puri. Other than Russia, the delegation will visit Spain, Greece, Slovenia, and Latvia. Vinay Kumar, Indian Ambassador to the Russian Federation had welcomed the delegation to Russia. Earlier on Saturday, the delegation paid floral tributes to Mahatma Gandhi's statue at the Indian embassy in Moscow. In a post on X, Kanimozhi informed that she engaged in a dialogue with H.E. Mikhail Fradkov, former PM of Russia and Director of RISS, along with MPs of the delegation. She wrote, "Honored to engage in a constructive dialogue with H.E. Mikhail Fradkov, former Prime Minister of Russia & Director of RISS, along with MPs as part of our parliamentary delegation. We discussed global security challenges and the collective fight against terrorism." Operation Sindoor The Indian Armed Forces launched Operation Sindoor during the early hours of May 7, hitting terrorist infrastructure in Pakistan and Pakistan-occupied Jammu and Kashmir (PoJK). Altogether, nine sites were targeted. These steps were taken to avenge the gruesome terrorist attack of April 22 in Jammu and Kashmir's Pahalgam in which 25 Indian citizens and one Nepali citizen were killed. After Operation Sindoor, Pakistan launched a swarm of drones and missile attacks in various territories of India. All-Party Delegations On May 17, it was announced that seven All-Party Delegations will visit key partner nations, including members of the United States Security Council (UNSC). As per a statement of the Ministry of Parliamentary Affairs, the Delegations will project India's national consensus and resolute approach to combating terrorism in all forms and manifestations. The seven Delegations would carry forth to the world India's message of "zero tolerance against terrorism".