Durie-Salmon Staging (historical)

Historical Staging: The Durie-Salmon system classifies myeloma based on estimated tumor cell mass. Note: Modern clinical practice primarily uses the Revised-ISS (R-ISS).

Laboratory Parameters

Haemoglobin (g/dL)

Serum Calcium (mg/dL)

Creatinine (mg/dL)

Bone & Protein

Bone X-Ray Findings

IgG (g/dL)

IgA (g/dL)

BJ (g/24h)

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Historical classification and staging of Multiple Myeloma.

Estimating myleoma cell mass based on clinical and laboratory parameters.

Educational or retrospective data analysis (note: largely superseded by R-ISS).

Patient Population

Patients with confirmed Multiple Myeloma. Historically used to differentiate low, intermediate, and high tumor burden.

When Not to Rely on This Score Alone

Modern prognostication — the Revised International Staging System (R-ISS) is the current gold standard, incorporating LDH and cytogenetics.

Monitoring response — use IMWG response criteria (e.g., sCR, VGPR, PR) rather than staging systems.

How it Works

Stage I (Low Cell Mass)

Haemoglobin > 10 g/dL

Serum Calcium < 12 mg/dL

Normal bone x-ray or solitary plasmacytoma

Low M-protein: IgG < 5 g/dL, IgA < 3 g/dL, Bence Jones < 4g/24h

Stage III (High Cell Mass)

Haemoglobin < 8.5 g/dL

Serum Calcium > 12 mg/dL

Advanced lytic bone lesions (≥ 3)

High M-protein: IgG > 7 g/dL, IgA > 5 g/dL, Bence Jones > 12g/24h

Stage II (Intermediate)

Neither Stage I nor Stage III.

Substaging (Renal Function)

Substage	Criteria
A	Serum Creatinine < 2.0 mg/dL
B	Serum Creatinine ≥ 2.0 mg/dL

Last Comprehensive Review: 2026-07-17

In Recent Clinical News

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Durie-Salmon Staging (historical)

Laboratory Parameters

Bone & Protein

When to Use

When to Use

Patient Population

When Not to Rely on This Score Alone

How it Works

Stage I (Low Cell Mass)

Stage III (High Cell Mass)

Stage II (Intermediate)

Substaging (Renal Function)

Clinical Pearls

Historical Context

The Evidence

Primary Score

A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival.

Origins & History

Development

In Recent Clinical News

Durie-Salmon Staging (historical)

Laboratory Parameters

Bone & Protein

When to Use

When to Use

Patient Population

When Not to Rely on This Score Alone

How it Works

Stage I (Low Cell Mass)

Stage III (High Cell Mass)

Stage II (Intermediate)

Substaging (Renal Function)

Clinical Pearls

Historical Context

The Evidence

Primary Score

A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival.

Origins & History

Development

In Recent Clinical News