ISS (Myeloma)

ISS (International Staging System): Standard biochemical staging for MM. Uses Serum Beta-2-Microglobulin and Albumin.

Beta-2 Microglobulin (mg/L)

Serum Albumin (g/dL)

Clinical Stage (ISS)

—

Enter lab values to determine stage.

Guidelines & Evidence

Verified

Last Review: 2026-07-17

When to Use

Baseline staging of patients with newly diagnosed Multiple Myeloma.

Predicting overall survival (OS) based on serum protein biomarkers.

Standardizing patient cohorts for clinical trials.

Patient Population

Adult patients with symptomatic Multiple Myeloma.

When Not to Rely on This Score Alone

Smoldering Myeloma / MGUS — these conditions use different progression risk models (e.g., 20/2/20 criteria).

Relapsed Myeloma — ISS is intended for baseline use; its utility in relapsed disease is less robust.

Modern Risk Assessment — ISS is purely biochemical. For most patients, the Revised ISS (R-ISS) should be used to incorporate cytogenetics (FISH) and LDH.

How it Works

Criteria

Stage	Definition
I	Serum β2-microglobulin < 3.5 mg/L AND Serum Albumin ≥ 3.5 g/dL
III	Serum β2-microglobulin ≥ 5.5 mg/L
II	Neither Stage I nor Stage III

Outcomes (Original Era)

Stage	Median Survival (Months)
I	62
II	44
III	29

Last Comprehensive Review: 2026-07-17

Recent Journal Updates

British J HaematologyJul 22, 2026

Adjusted delivery, stronger outcomes: Selinexor therapeutic adaptation and positioning in previously treated multiple myeloma

Clinical Context

We think this might be relevant to the clinical guidance for International Staging System (ISS) for Multiple Myeloma.

British J HaematologyJul 22, 2026

Prognostic significance of dynamic minimal residual disease trajectories in newly diagnosed multiple myeloma

Clinical Context

We think this might be relevant to the clinical guidance for International Staging System (ISS) for Multiple Myeloma.

WHO NewsJul 15, 2026

Global childhood immunization coverage inches forward despite conflict and hesitancy – UNICEF, WHO

Clinical Context

We think this might be relevant to the clinical guidance for International Staging System (ISS) for Multiple Myeloma.

ISS (Myeloma)

—

When to Use

When to Use

Patient Population

When Not to Rely on This Score Alone

How it Works

Criteria

Outcomes (Original Era)

Clinical Pearls

The Power of Beta-2

The Evidence

Primary Score

International staging system for multiple myeloma.

Origins & History

Development

Recent Journal Updates

ISS (Myeloma)

—

When to Use

When to Use

Patient Population

When Not to Rely on This Score Alone

How it Works

Criteria

Outcomes (Original Era)

Clinical Pearls

The Power of Beta-2

The Evidence

Primary Score

International staging system for multiple myeloma.

Origins & History

Development

Recent Journal Updates