Revised International Staging System for Myeloma (R-ISS)
Revised International Staging System (R-ISS) for multiple myeloma. Incorporates standard ISS staging with high-risk cytogenetics and LDH to improve prognostic stratification.
Score interpretation
→ R-ISS Stage I: ISS Stage I + no high-risk cytogenetics + normal LDH. Median OS >7 years. Standard induction (VRd or Dara-VRd); ASCT if eligible; lenalidomide maintenance. Consider minimal residual disease (MRD) assessment.
→ R-ISS Stage II: Not Stage I or III criteria. Median OS ~5 years. Bortezomib-based induction; ASCT if eligible; lenalidomide ± bortezomib maintenance. MRD monitoring; haematology MDT.
→ R-ISS Stage III: ISS Stage III + (high-risk cytogenetics OR elevated LDH). Median OS ~2 years. High-intensity treatment: Dara-VRd induction; tandem ASCT or ASCT + consolidation; bortezomib maintenance; consider clinical trial; intensive MRD monitoring.
Interpretation bands for the R-ISS Myeloma. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Fong Clinical Risk Score for Colorectal Cancer Recurrence · Oncology
- CRASH Score for Chemotherapy Risk Assessment in Elderly Patients · Oncology
- Ann Arbor Staging System for Lymphoma · Oncology
- Rai Staging System for CLL · Oncology
- Follicular Lymphoma International Prognostic Index (FLIPI) · Oncology
- International Staging System for Multiple Myeloma (ISS) · Oncology
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.