Multiple Myeloma: Stages

April 17, 2018

Multiple Myeloma: Stages

What does the stage of a cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to determine this. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

How is multiple myeloma staged?

Different systems have been used to stage multiple myeloma. The system most commonly used today is the Revised International Staging System (R-ISS).

R-ISS is based on these 4 lab test results for the person with multiple myeloma:

  1. How much beta-2 microglobin (B2M) is in the blood?

  2. How much albumin is in the blood?

  3. How much lactate dehydrogenase (LDH)  is in the blood

  4. What are the DNA changes in the myeloma cells? (This is called cytogenetics.)

What are the stages of multiple myeloma?

The R-ISS divides multiple myeloma into 3 stages. 

Stage I includes myelomas with all of the following:

  • B2M is less than 3.5 mg/dL.

  • Albumin is 3.5 g/dL or higher.

  • LDH is normal.

  • The myeloma cells do not have any high-risk chromosome changes or abnormalities.

Stage II includes all myelomas that do not fall into stage I or stage III.

Stage III includes myelomas with a B2M of 5.5 mg/dL or higher, plus at least one of the following:

  • The myeloma cells have high-risk chromosome abnormalities.

  • LDH is higher than normal.

Other factors

Along with the stage of a myeloma, other factors can also affect a person's outlook (prognosis). For instance, people who are younger tend to do better than those who are older. People who have better kidney function also tend to do better than those whose kidneys are more affected by the myeloma. 

Talking with your healthcare provider

Once your cancer is staged, talk with your healthcare provider about what the stage means for you. Make sure to ask questions and talk about your concerns.


April 17, 2018


Patient education: Multiple myeloma symptoms, diagnosis, and staging (Beyond the Basics). UpToDate., Staging and prognostic studies in multiple myeloma. UpToDate.

Reviewed By:  

Cunningham, Louise, RN,Stump-Sutliff, Kim, RN, MSN, AOCNS