A NEW IMPROVED CLINICAL STAGING SYSTEM FOR MULTIPLE-MYELOMA BASED ON ANALYSIS OF 123 TREATED PATIENTS

Abstract

The effect of the presenting clinical features on survival time was evaluated in 173 patients of a population of 201 individuals with multiple myeloma observed during the 11 yr period 1960 to Jan. 1, 1971. Complete follow-up was continued until Dec. 1978. Of these patients 105 came from the city of Malmo [Sweden] and constitute a complete nonselected myeloma population. Bivariate correlation and multivariate regression analyses showed that the survival (i.e., the prognosis) could be accurately predicted in Ig[immunoglobulin]G and pure Bence Jones myeloma patients from serum creatinine level, serum Ca levels and bone marrow plasma cell percentage; and in IgA myeloma patients from hemoglobin level, serum Ca level and serum M-component level. The results were synthesized to produce a simple and reliable clinical staging system with 3 stages (i.e., risks of death). To facilitate the clinical application, multivariate regression equations were developed to optimally predict the prognosis, and graphs were constructed in order to make the staging of the myeloma patients easier and quicker. The comparison of the duration of survival between the 3 groups of staged patients confirmed the high reliability to the present staging system.