Multiple Myeloma Staging

If the biopsy shows that you have multiple myeloma, your doctor needs to learn the extent (stage) of the disease to plan the best treatment.

Staging may involve having more tests:

• Blood tests: For staging, the doctor considers the results of blood tests, including albumin and beta-2-microglobulin.
• CT scan: An x-ray machine linked to a computer takes a series of detailed pictures of your bones.
• MRI: A powerful magnet linked to a computer is used to make detailed pictures of your bones.

Doctors may describe multiple myeloma as:

• Smoldering
• Stage I multiple myeloma
  In stage I multiple myeloma, the blood levels are as follows:
  • the beta-2-microglobulin level is lower than 3.5 mg/L; and
  • albumin level is 3.5 g/dL or higher.
• Stage II multiple myeloma
  In stage II multiple myeloma, the blood levels are in between the levels for stage I and stage III.
• Stage III multiple myeloma 
  In stage III multiple myeloma, the blood level of beta-2-microglobulin is 5.5 mg/L or higher and the patient also has one of the following:
  • high levels of lactate dehydrogenase (LDH); or
  • certain changes in the chromosomes.

The stage takes into account whether the cancer is causing problems with your bones or kidneys. Smoldering multiple myeloma is early disease without any symptoms. For example, there is no bone damage. Early disease with symptoms (such as bone damage) is Stage I. Stage II or III is more advanced, and more myeloma cells are found in the body.