Staging and survival in multiple myeloma

The records of 91 patients with multiple myeloma were reviewed and staging was performed according to Durie & Salmon (1). Patients with progressive disease were re-staged. Patients first diagnosed in stage I were younger than patients first diagnosed in stage III and survived longer than patients in stages II or III. The duration of stage I was longer than the duration of stages II and III. When patients in stage I-II progressed into stage III, their age and remaining survival time were similar to the age and survival of patients first diagnosed in stage III. These findings are compatible with the hypothesis that myeloma stage I precedes myeloma stage III and is often diagnosed by chance. It is suggested that patients with myeloma stage I should be omitted from comparisons between different myeloma populations.