Key Points for This Section

After multiple myeloma and other plasma cell neoplasms have been diagnosed, tests are done to find out the amount of cancer in the body. The stage of multiple myeloma is based on the number of myeloma cells in the body. The following stages are used for multiple myeloma: Stage I multiple myeloma Stage II multiple myeloma Stage III multiple myeloma Other plasma cell neoplasms are staged differently than multiple myeloma. Isolated plasmacytoma of bone Extramedullary plasmacytoma Macroglobulinemia Monoclonal Gammopathy of Undetermined Significance

After multiple myeloma and other plasma cell neoplasms have been diagnosed, tests are done to find out the amount of cancer in the body.

The process used to find out the amount of cancer in the body is called staging. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

• X-ray: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body such as the bone marrow. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radionuclide glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
• Bone densitometry: A procedure that uses a special type of x-ray to measure bone loss.

Certain tests may be repeated to see how well the treatment is working.

The stage of multiple myeloma is based on the number of myeloma cells in the body.

There are three stages for multiple myeloma. The number of myeloma cells in the body is determined by the following:

• Level of hemoglobin in the blood.
• Levels of calcium and creatinine in the blood.
• Amount of bone damage.
• Amount of antibody M protein in the blood and/or urine.

It is also important to know how well the kidneys are working.

The following stages are used for multiple myeloma:

Stage I multiple myeloma

In stage I multiple myeloma, there is a low number of myeloma cells in the body.

Stage II multiple myeloma

In stage II multiple myeloma, there is a moderate number of myeloma cells in the body.

Stage III multiple myeloma

In stage III multiple myeloma, there is a large number of myeloma cells in the body.

Other plasma cell neoplasms are staged differently than multiple myeloma.

Isolated plasmacytoma of bone

In isolated plasmacytoma of bone, one plasma cell tumor is found in the bone, less than 5% of the bone marrow is made up of plasma cells, and there are no other signs of cancer.

Extramedullary plasmacytoma

One plasma cell tumor is found in the soft tissue but not in the bone or the bone marrow.

Macroglobulinemia

There is no standard staging system for macroglobulinemia.

Monoclonal Gammopathy of Undetermined Significance

In monoclonal gammopathy of undetermined significance (MGUS), the amount of M protein in the blood stays the same, less than 10% of the bone marrow is made up of plasma cells, and the patient has no signs of cancer.

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