changes in protein profiles in bortezomib applied multiple myeloma ...
changes in protein profiles in bortezomib applied multiple myeloma ...
changes in protein profiles in bortezomib applied multiple myeloma ...
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
1.2.6.1. The Durie-Salmon Stag<strong>in</strong>g System<br />
The Durie-Salmon Stag<strong>in</strong>g System was developed <strong>in</strong> the mid-1970s and most<br />
commonly used stag<strong>in</strong>g system for patient with MM (Jacobson et al., 2003).<br />
This system is basically depends on four factors ;<br />
The amount of abnormal monoclonal immunoglobul<strong>in</strong> <strong>in</strong> the blood or<br />
ur<strong>in</strong>e,<br />
The amount of calcium <strong>in</strong> the blood,<br />
The amount of hemoglob<strong>in</strong> <strong>in</strong> the blood,<br />
The severity of bone damage based on x-rays.<br />
Table 1.4. Durie-Salmon Stag<strong>in</strong>g System <strong>in</strong> MM<br />
(Source : Durie and Salmon, 1975)<br />
Stage Criteria<br />
Hemoglob<strong>in</strong> level > 10 g / 100 ml,<br />
(Hemoglob<strong>in</strong> level is slightly under the normal level)<br />
I<br />
Calcium levels <strong>in</strong> blood ≤ 12 mg / 100 ml,<br />
(Normal calcium levels <strong>in</strong> blood)<br />
Normal bone structure,<br />
(Bone x-ray results either appear normal or <strong>in</strong>dicate that<br />
I<br />
only one area of bone damage)<br />
Relatively low monoclonal immunoglobul<strong>in</strong> rates<br />
<strong>in</strong> blood or ur<strong>in</strong>e ;<br />
IgG value < 5 g / 100 ml<br />
IgA value < 3 g / 100 ml<br />
Ur<strong>in</strong>e light cha<strong>in</strong> monoclonal immunoglobul<strong>in</strong><br />
on electrophoresis < 4 g / 24 hours.<br />
II A moderate number of malignant plasma cells are present.<br />
Features of this stage are between stage I and III.<br />
III<br />
Hemoglob<strong>in</strong> level > 8.5 g / 100 ml,<br />
(Low hemoglob<strong>in</strong> level)<br />
Calcium levels <strong>in</strong> blood > 12 mg / 100 ml,<br />
(High calcium levels <strong>in</strong> blood)<br />
Advanced lytic bone lesions<br />
(Bone x-ray results <strong>in</strong>dicate that three or more areas of bone)<br />
High monoclonal immunoglobul<strong>in</strong> rates<br />
<strong>in</strong> blood or ur<strong>in</strong>e ;<br />
IgG value > 7 g / 100 ml<br />
IgA value > 5 g / 100 ml<br />
Ur<strong>in</strong>e light cha<strong>in</strong> monoclonal immunoglobul<strong>in</strong><br />
on electrophoresis > 12 g / 24 hours.<br />
17