[Prognostic value of the new international staging system in multiple myeloma. Comparison with Durie-Salmon staging system].
BACKGROUND
Since 1975, the Durie-Salmon staging system (D&S) has been a widely accepted prognostic classification of multiple myeloma (MM) patients. Recently, the new International Staging System (ISS) was developed using only the values of albumin and beta2-microglobulin.


OBJECTIVE
To compare survival of patients with MM treated in six medical centers in Chile according to the D&S system and the new ISS.


METHODS
Retrospective analysis of demographic information, clinical features and survival rate of patients treated between 1998 and 2002, and grouped according to both systems.


RESULTS
Information of 81 patients aged 38 to 90 years (43 women) was retrieved. According D&S system 11% were in stage I 12% in stage II and 73% in stage III According to ISS, 34% were in stage I 35% in stage II and 31% in stage III Median of survival of all patients was 32 months. Both staging systems had a prognostic value. However, median survival for the three stages of the ISS system was significantly different (67, 29 and 14 months in stages III and III, respectively, p =0.02). Patients in advanced stages II and III of the ISS, had a higher frequency of anemia, hypercalcemia, renal failure and hypoalbuminemia. In stages II and III of ISS the presence of renal failure was associated with a non significantly different lower survival.


CONCLUSIONS
The ISS is a simple and effective grouping method for patients with MM, that predicts survival. The presence of renal insufficiency might identify a subgroup of patients included in stages II and III of ISS with a higher mortality.
Conté L
Guillermo
G
Sección de Hematología, Hospital Clínico, Universidad de Chile, Santos Dumont 999, Independencia, Santiago, Chile. gfconte@gmail.com
Figueroa M
Gastón
G
Lois V
Vivianne
V
Cabrera C
María Elena
ME
León R
Alvaro
A
García L
Hernán
H
Rojas R
Hernán
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002677:Chile / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis