Durie-Salmon Staging System

The Durie-Salmon has historically been the most widely used staging system to assess and classify multiple myeloma. The process of staging myeloma helps doctors evaluate the disease and propose an effective myeloma treatment plan. The Durie-Salmon system gauges the clinical stage of disease (stage I, II, or III) by assessing four measurements: levels of M protein, the number of lytic bone lesions, hemoglobin values (a measure of the number of red blood cells in the blood), and serum calcium levels. Stages are further divided according to renal (kidney) function.

Durie-Salmon criteria:

Stage I
• Hemoglobin value 10 g/dL
• Serum calcium value normal or =12 mg/dL
• Bone x-ray, normal bone structure (scale 0) or solitary bone plasmacytoma only
• Low M-component production rate (IgG value <5 g/dL; IgA value <3 g/dL; Bence Jones protein <4 g/24 hr)

Stage II*
Neither stage I nor stage III
Neither stage I nor stage III

Stage III
On or more of the following:
• Hemoglobin value 12 mg/dL
• Advanced lytic bone lesions (scale 3)
• High M-component production rate – IgG value >7 g/dL; IgA value>5 g/dL; Bence Jones protein >12 g/24 h

Durie-Salmon sub classifications (either A or B)
A: Relatively normal renal function (serum creatinine value <2.0 mg/dL)
B: Abnormal renal function (serum creatinine value =2.0 mg/dL)

To learn more about the various diagnostic tests used for staging myeloma, visit the Multiple Myeloma Knowledge Center.