A new improved clinical staging system for multiple myeloma based on
analysis of 123 treated patients
G Merlini, JG Waldenstrom and SD Jayakar
The effect of the presenting clinical features on survival time was
evaluated in 173 patients of a population of 201 individuals with multiple
myeloma observed at Malmo General Hospital during the 11-yr period 1960 to
January 1, 1971. Complete follow-up was continued until December 1978.
One-hundred and five of the patients came from the city of Malmo and
constitute a complete nonselected myeloma population. Bivariate correlation
and multivariate regression analyses showed that the survival (i.e., the
prognosis) could be accurately predicted in IgG and pure Bence Jones
myeloma patients from (A) serum creatinine level, (B) serum calcium level,
and (C) bone marrow plasma cell percentage; and in IgA myeloma patients
from (A) hemoglobin level, (B) serum calcium level, and (C) serum
M-component level. The results were synthesized to produce a simple and
reliable clinical staging system with three stages (i.e., risks of death).
To facilitate the clinical application, multivariate regression equations
were developed to optimally predict the prognosis, and graphs were
constructed in order to make the staging of the myeloma patients easier and
quicker. The comparison of the duration of survival between the three
groups of staged patients confirmed the high reliability of the present
staging system.
Volume 55,
Issue 6,
pp. 1011-1019,
06/01/1980
Copyright © 1980 by The American Society of Hematology
