Durie-Salmon Staging System (Multiple myeloma)

Additional Information

Score Description

The Durie-Salmon staging system is a staging system to classify patients with multiple myeloma, which was introduced in 1975. The staging system incorporates several factors correlating with tumor cell mass, however prognostic assessment is only possible to a limited extent. As an example, the system incorporates the observer-dependent and subjective quantification of lytic lesions on skeletal survery. In this respect, the Durie-Salmon PLUS staging system was introduced in 2003.


Stages Criteria
I ALL following criteria:
  • Hb > 100 g/l
  • Calcium normal (2.2–2.65 mmol/l)
  • At the most one osteolysis (MRI: < 5 focal foci or mild diffuse BM-Infiltration)
  • IgG < 50 g/l, IgA < 30 g/l, free light chain in the urine < 4 g/24h
II Neither stage I nor stage II
III At least one of the following criteria:
  • Hb < 85 g/l
  • Calcium > 3 mmol/l
  • Multiple osteolysis (MRI: > 20 bone foci or severe diffuse BM-Infiltration)
  • IgG > 70 g/l, IgA > 50 g/l, free light chain in the urine > 12 g/24h
A creatinine < 177 μmol/l
B creatinine > 177 μmol/l

Hb = hemoglobin; MRI = magnetic resonance imaging; Ig = Immunoglobulin; BM = bone marrow.

Further Reading

Durie BG et al. A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival. Cancer. 1975 Sep;36(3):842-54.