R-ISS (Revised ISS)

Baseline staging of newly diagnosed Multiple Myeloma in the modern era.

Integrating clinical biomarkers (ISS) with genomic (FISH) and metabolic (LDH) risk factors.

Providing the most accurate prediction of overall and progression-free survival.

Patients without FISH data — standard ISS must be used instead.

Age-specific considerations — while R-ISS is robust, patient fitness (e.g., IMWG Frailty Index) is equally important for therapy selection.

R2-ISS — for even more granular genomic integration (including 1q gain), newer updates like R2-ISS may be preferred in clinical trials.