can anyone explain what "Level 3" multiple myeloma is...and any info?

Answer 1

Hi,

very few docs are using the staging system for MM because of the large number of variables. If your doc is using staging, you should make sure they are uptodate and are MM specialist. By asking the question here, I assume there msut be some communication issue with the doc; he should have explained this to you.

There are GREAT websites and organizations for MM - you can request a large number of books form each of them.:

www.myeloma.org
www.lls.org
www.multiplemyeloma.org

the myeloma.org also has a hotline for specific questions

good luck

Jewells
33 months and still here

Answer 2

Staging
International Staging System
The International Staging System (ISS) for myeloma was published by the International Myeloma Working Group in 2003 [2]:

Stage I: β2-microglobulin (β2M) < 3.5 mg/L, albumin >= 3.5 g/dL
Stage II: β2M < 3.5 and albumin < 3.5; or β2M between 3.5 and 5.5
Stage III: β2M > 5.5
Durie-Salmon staging system
First published in 1975, the Durie-Salmon staging system [3] is still in use, but has largely been superseded by the simpler ISS:

stage 1: all of
Hb > 10g/dL
normal calcium
Skeletal survey: normal or single plasmacytoma or osteoporosis
Serum paraprotein level < 5 g/dL if IgG, < 3 g/dL if IgA
Urinary light chain excretion < 4 g/24h
stage 2: fulfilling the criteria of neither 1 nor 3
stage 3: one or more of
Hb < 8.5g/dL
high calcium > 12mg/dL
Skeletal survey: 3 or more lytic bone lesions
Serum paraprotein >7g/dL if IgG, > 5 g/dL if IgA
Urinary light chain excretion > 12g/24h
Stages 1, 2 and 3 of the Durie-Salmon staging system can be divided into A or B depending on serum creatinine:

A: serum creatinine < 2mg/dL (< 177 umol/L)
B: serum creatinine > 2mg/dL (> 177 umol/L)

Answer 3

Multiple myeloma (also known as myeloma or plasma cell myeloma) is a progressive hematologic (blood) disease. It is a cancer of the plasma cell, an important part of the immune system that produces immunoglobulins (antibodies) to help fight infection and disease. Multiple myeloma is characterized by excessive numbers of abnormal plasma cells in the bone marrow and overproduction of intact monoclonal immunoglobulin (IgG, IgA, IgD, or IgE) or Bence-Jones protein (free monoclonal κ and λ light chains). Hypercalcemia, anemia, renal damage, increased susceptibility to bacterial infection, and impaired production of normal immunoglobulin are common clinical manifestations of multiple myeloma. It is often also characterized by diffuse osteoporosis, usually in the pelvis, spine, ribs, and skull.

Answer 4

"Multiple myeloma is a debilitating malignancy that is part of a spectrum of diseases. A feature of this disease is that the antibody-forming cells (ie, plasma cells) are malignant and, therefore, may cause unusual manifestations.

The disease can cause systemic ailments, including infections and renal (kidney) failure, and local catastrophes, including pathologic fractures and spinal cord compression. Although patients benefit from treatment (ie, longer life, less pain, fewer complications), currently no cure exists. Recent advances in therapy have helped to lessen the occurrence and severity of adverse effects.

Multiple myeloma can cause a wide variety of problems. The proliferation of plasma cells may interfere with the normal production of blood cells.The cells may cause soft tissue masses (plasmacytomas) or lytic lesions in the skeleton. Feared complications of this malignancy are bone pain, and spinal cord compression. patients have a high prevalence of infection, especially with encapsulated organisms. The overproduction of these antibodies may lead to hyperviscosity, amyloidosis, and renal failure.Multiple myeloma affects the kidneys in several waysSpinal cord compression is one of the most severe adverse effects of myeloma. Reports indicate that as many as 20% of patients develop spinal cord compression at some point during the course of their disease. Symptoms typically include back pain, weakness or paralysis in the legs, numbness, or dysesthesias in the lower extremities. .A frequent complication of multiple myeloma is pathologic fractures.


Causes of multiple Myeloma:

(a)Genetic causes
The Mayo clinic found disease in 8 siblings out of 440 patients; these 8 siblings had different heavy chains but the same light chains.
Ongoing research is investigating whether HLA-Cw5 or HLA-Cw2 may play a role in the pathogenesis of myeloma.
Environmental or occupational causes: Case-controlled studies have suggested a significant risk of developing myeloma in individuals with significant exposures in the agriculture, food, and petrochemical industries. Long-term (>20 y) exposure to hair dyes has been tied to an excessive risk of developing myeloma.
MGUS: Approximately 19% of patients with MGUS develop multiple myeloma within 2-19 years.

(b)Radiation:
Radiation has been linked to the development of myeloma.
In 109,000 survivors of the bombing of Nagasaki, 29 died from myeloma from 1950-1976; however, some recent studies do not confirm that these survivors have an increased risk of developing myeloma.


The prognosis for survival in unselected patients with multiple myeloma is 3 years (ie, median survival).

The stage number 3 refers to

Staging
International Staging System
Stage refers to the extent of the cancer and whether the disease has spread from the original site to other parts of the body.
Staging, the process of finding out how much the cancer has advanced, is important for treatment options and prognosis. Prognosis is a prediction of the course of disease – the outlook for the chances of survival. It depends on the stage of the cancer. Knowing all you can about staging lets you take a more active role in making informed decisions about your treatment.

There are 3 stages for the classification of the extent of the multiple myeloma. Stage I indicates the smallest amount of tumor, and stage III indicates the largest amount of tumor:

Stage III

Serum beta-2 microglobulin is greater than 5.5. (you can read about this test here: http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/beta2-microglobulin_test.jsp

Albumin is above 3.5. (you can read about the albumin test here:

http://www.labtestsonline.org/understanding/analytes/albumin/test.html)
Survival rates by stage:

The approximate overall median survival for the International System stages is as follows: (median means the time that half the patients have died)

Stage 5-year survival
I 62 months
II 44 months
III 29 months




The International Staging System (ISS) for myeloma was published by the International Myeloma Working Group in 2003 [2]:

Stage I: β2-microglobulin (β2M) < 3.5 mg/L, albumin >= 3.5 g/dL
Stage II: β2M < 3.5 and albumin < 3.5; or β2M between 3.5 and 5.5
Stage III: β2M > 5.5

Answer 5

see here:
http://en.wikipedia.org/wiki/Multiple_myeloma

it depends on the diagnostic method and he type of multiple myeloma