Plasma cells are white blood cells that produce antibodies to fight infections by recognizing and attacking germs. Cancer in any form is a life-threatening disease, and multiple myeloma is a type of cancer that forms in the plasma cells. The condition overpowers healthy blood cells and accumulates in the bone marrow. The cancer cells then reverse the production of healthy antibodies and start producing abnormal proteins instead, leading to severe complications.

Several symptoms are associated with multiple myeloma, which vary according to the stage of the disease. Before looking at the different stages of multiple myeloma, let’s look at some of its symptoms:

• Persistent bone pain, especially in the back, spine, or chest
• Weight loss
• Fatigue and loss of appetite
• Constipation
• Confusion
• Weakness and numbness in the legs
• Excessive thirst
• Nausea
• Frequent infections and fever

The stages of multiple myeloma
A stage in multiple myeloma is a number assigned to indicate how severe the disease is at a given point. The stage often decides the type of treatment a patient needs to undergo. The following are some tests performed to diagnose multiple myeloma that also indicate the stage of the condition:

• Blood tests
• Urine tests
• Examining the bone marrow
• Imaging tests like X-rays, MRI, and CT scan
• Genetic tests of the cancer cells

The stage and the risk category help a doctor understand the patient’s medical condition and recommend the right treatment option. There are two basic categories or systems of staging multiple myeloma; read on to know them.

The Durie-Salmon System
There are three different stages of multiple myeloma, and this system considers the following factors in determining the severity of the disease:

• The number of myeloma cells
• The degree of bone damage these cells have caused
• M-protein levels in the blood or urine
• Calcium levels in the blood
• Albumin and hemoglobin levels to check whether enough healthy blood cells are produced
• How well the kidneys are functioning

The International Staging System (ISS)
This system considers albumin and beta-2 microglobulin levels in the blood. The higher the stage, the more advanced the condition is. In general, the different stages of multiple myeloma are as follows:

• Stage 0
  Described as smoldering myeloma, this slow-growing condition is influenced by an increase in plasma cells in the bone marrow with monoclonal proteins. This stage uses a “wait and watch” approach for treatment, so it is not administered unless the disease progresses, but diagnostic tests are closely monitored.
• Stage 1
  A small number of myeloma cells are present, along with slightly higher beta-2 microglobulin levels and lower albumin levels.
• Stage 2
  An intermediate stage, this is recorded if the levels fall between those for the initial and advanced stages.
• Stage 3
  The number of myeloma cells is high, and the most advanced stage includes high levels of beta-2 microglobulin, along with low levels of albumin.