When a person is diagnosed with multiple myeloma, it is important for the doctor to understand the severity of the condition so that they can prescribe the necessary medications and administer appropriate treatment. Doctors figure out the different stages of multiple myeloma using different methods. There are two systems available for marking the stages of multiple myeloma: the Revised International Staging System and the Durie-Salmon System.

Revised International Staging System (RISS)
This is the staging system most used by doctors in today’s times. The RISS calculates many factors and estimates how advanced cancer is. The different stages of multiple myeloma according to the international method is calculated in three stages: I, II, and III, and the higher the stage of the disease, the more severe it is.

According to this system, the aggressiveness of the cancer depends on factors like finding out the quantities of proteins like Beta-2 microglobulins and albumin in the body, along with studying the genetic graph of the cells to look for any abnormalities.

• Stage I
  In this stage, the structures of the genes appear normal and show no sign of corruption. The degrees of Beta -2 microglobulins, albumin and LDH see no changes.
• Stage II
  Among the different stages of multiple myeloma, this stage records none to a slight increase in the Beta-2 microglobulin levels. The level of albumin gets lower.
• Stage III
  This is the last stage in this system and signifies advanced multiple myeloma. The Beta-2 microglobulin and albumin levels are at opposite ends of the spectrum, with the B2M levels at the higher end and albumin at the lower end.

Durie-Salmon System
The Durie-Salmon System considers various factors, including the amount of blood calcium, hemoglobin and albumin in the blood, the M-protein levels in the urine or blood, the number of myeloma cells in the body as well as the damage caused by them on the bones.

In this system, the different stages of multiple myeloma are further divided into Groups A and B, based on the damage caused to the kidneys. Group A means that the kidney is functioning normally, while Group B refers to an abnormally-functioning kidney as it is damaged.

• Stage 1
  In this stage, there is no change in the levels of hemoglobin in the blood. The albumin and B2M levels, both are at stagnation, and the protein levels in the blood or urine are also low.
• Stage 2
  A higher number of myeloma cells are present in the body, and this stage is one that is given if the symptoms do not fit stage one as well as three.
• Stage 3
  This is the most life-threatening stage with a large distribution of myeloma cells. The other characteristics of this stage are hypercalcemia, anemia, and high protein levels in blood or urine.