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DS Stage III Plasma Cell Myeloma
Definition 1
Plasma cell myeloma with one or more of the following: 1. Hemoglobin less than 8.5 g/dL. 2. Serum calcium greater than 12.0 mg/dL. 3. More than three lytic bone lesions. 4. High M protein production as shown by: a. IgG greater than 7.0 g/dL. b. IgA greater than 5.0 g/dL. c. Urinary kappa or lamda greater than 12.0 g/24 hours. Estimated myeloma cell mass: greater than 1.2 trillion (1012)/m2 (high burden). The following subclassification of stages is used: a. Creatinine less than 2.0 mg/dL. b. Creatinine greater than or equal to 2.0 mg/dL. Serum beta-2-microglobulin has been shown to be a reliable marker for prognosis. Since the great majority of symptomatic myeloma patients are classified as stage III by the Durie/Salmon criteria, this staging system has not proven to be very useful for identifying the patients with intermediate and poor prognosis. Note that the newer International Staging System defines stage III quite differently: Beta-2-microglobulin greater than or equal to 5.5 (median survival of 29 months). (NCI Thesaurus/PDQ)
Definition 2
A relatively large number of cancer cells have spread throughout the body. There may be one or more of the following: 1) a decrease in the number of red blood cells, causing anemia; 2) the amount of calcium in the blood is very high, because the bones are being damaged; 3) more than three bone tumors (plasmacytomas) are found; or 4) high levels of M protein are found in the blood or urine. (NCI Dictionary)
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