title: Staging systems and prognostic factors as a guide to therapeutic decisions in multiple myeloma.
abstract: Multiple myeloma (MM) patients have a highly variable disease course and survival varies from a few months to more than 10 years. Numerous prognostic factors have been identified, including age, performance status (PS), serum albumin, beta2-microglobulin (beta2M), lactate dehydrogenase (LDH), renal function, genetic factors, and serum free light chains (sFLCs) or their ratio (sFLCR). Several models have been built to separate patients into various risk groups with different outcomes. Staging systems need to be simple, accurate, and readily available in order to effectively guide treatment decisions now that effective treatments exist that prolong survival. The International Staging System (ISS) is currently in use; it is highly prognostic but presents some limitations. We suggest that the ISS prognostic potential could be improved with the addition of sFLCR and eventually LDH.
authors.affiliation: First Department of Propedeutic Internal Medicine, National and Kapodistrian University of Athens Medical School, Laikon General Hospital, Athens, Greece. mck@ath.forthnet.gr
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Kyrtsonis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Maltezas
authors.forename: Tatiana
authors.initials: T
authors.lastname: Tzenou
authors.forename: Efstathios
authors.initials: E
authors.lastname: Koulieris
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Bradwell
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D007668:Kidney; D007770:L-Lactate Dehydrogenase; D009101:Multiple Myeloma / Q000097:blood* / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D012709:Serum Albumin; D015996:Survival Rate
chemical_list: D012709:Serum Albumin; D007770:L-Lactate Dehydrogenase