Prognosis
Updated: Aug 13, 2009
Any person’s individual multiple myeloma prognosis depends on several health factors. People who have kidney damage or who are older are more likely to have poorer prognoses. Additionally, doctors perform many tests to get an overall picture of how a person’s body is responding to myeloma.
Samples of a person’s bone marrow can be tested for different factors that affect prognoses. A lab test called the myeloma cell staging index or plasma cell labeling index can show the percentage of myeloma cells that are growing, with lower labeling indexes indicating a better prognoses.
Labs can also look for creatinine, C-reactive protein, and lactate dehydrogenase in the blood. These molecules are released in higher amounts in the blood when body tissues are damaged. Lower levels of these molecules make for better prognoses.
Another lab test looks at the chromosomes of a myeloma cell to see if there are certain chromosome changes that lead to poorer prognoses. For example, chromosome 13 has a retinoblastoma gene (Rb), which produces proteins that suppress myeloma cell production. However, when this chromosome is missing or defective, it results in a poorer prognosis because the cancerous cells continue to grow; sometimes becoming resistant to treatment.
Furthermore, doctors may use the International Staging System for Multiple Myeloma to determine the outlook for their patients. In this system, myeloma cases are divided into three stages depending on patients’ serum levels of two molecules, beta-2 microglobulin and albumin.
Doctors and scientists have data on the approximate median survival time for patients at each stage of multiple myeloma. Median survival time is the time at which half of the people at that stage have died. These times are counted from when patients begin treatment.
The following table shows the definitions of the different stages of the International Staging System and their associated median survival times. Keep in mind that the data for this table are based on people treated five to 25 years ago. According to the American Cancer Society, modern prognoses for patients getting treated with current techniques are likely to be better than the table shows.
International Staging System Stage Definitions and Median Survival Times
| International Staging System Stage | Serum Beta-2 Microglobulin and Albumin Levels | Median Survival Time |
| Stage I | Beta-2 Microglobulin: < 3.5 mg/L Albumin: ≥ 3.5 g/dL |
5 years, 2 months |
| Stage II | Beta-2 Microglobulin: between 3.5 and 5.5 mg/L Albumin: any level |
3 years, 8 months |
| OR | ||
| Beta-2 Microglobulin: < 3.5 mg/L Albumin: < 3.5 g/dL |
||
| Stage III | Beta-2 Microglobulin: > 5.5 mg/L Albumin: any level |
2 years, 5 months |
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- Dr. Craig Hofmeister On Testosterone And Multiple Myeloma
- Darzalex May Affect Different Uninvolved Immunoglobulins Differently
