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 ...
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By us<strong>in</strong>g the system <strong>in</strong>troduced by Durie and Salmon (Durie and Salmon) <strong>in</strong><br />
1975, MM has been divided <strong>myeloma</strong> <strong>in</strong>to three stages. Accord<strong>in</strong>g to this system, the<br />
risk of MM <strong>in</strong>creases from Stage I to Stage III. Thus, Stage I <strong>in</strong>dicates the smallest<br />
amount of tumor and stage III <strong>in</strong>dicates the largest amount of tumor.<br />
Large amounts of abnormal monoclonal immunoglobul<strong>in</strong> is an <strong>in</strong>dicator of<br />
many malignant plasma cells and advanced MM.<br />
The amount of calcium <strong>in</strong> the blood is directly related to bone destruction.<br />
Because, bones normally <strong>in</strong>clude lots of calcium. With the bone damage <strong>in</strong> MM,<br />
calcium <strong>in</strong> the bones are released <strong>in</strong>to the blood. Multiple areas of bone damage seen on<br />
x-rays <strong>in</strong>dicate an advanced stage of <strong>multiple</strong> <strong>myeloma</strong>.<br />
Hemoglob<strong>in</strong> level is another important factor to stage MM. It is ma<strong>in</strong>ly<br />
responsible for carry<strong>in</strong>g oxygen and the substance of red blood cells. In MM, malignant<br />
plasma cells occupy much of the bone marrow, <strong>in</strong> connection with this, the normal<br />
bone marrow cells have not enough space to produce red blood cells adaquately.<br />
Therefore, low hemoglob<strong>in</strong> level is equal to advanced MM.<br />
1.2.6.2. The International Stag<strong>in</strong>g System<br />
The International Stag<strong>in</strong>g System is similar to Durie-Salmon Stag<strong>in</strong>g System <strong>in</strong><br />
that it also divides MM <strong>in</strong>to three stages. System is based only on the Serum β-2<br />
Microglobul<strong>in</strong> and Serum Album<strong>in</strong> Levels.<br />
Table 1.5. International Stag<strong>in</strong>g System <strong>in</strong> MM<br />
(Source : Greipp et al., 2005)<br />
Stage Criteria<br />
I<br />
II<br />
Serum β-2 Microglobul<strong>in</strong> Level < 3.5 mg / L,<br />
Serum Album<strong>in</strong> ≥ 3.5 g / 100 ml,<br />
Serum β-2 Microglobul<strong>in</strong> Level < 3.5 mg / L<br />
but<br />
Serum Album<strong>in</strong> < 3.5 g / 100 ml<br />
or<br />
3.5 mg / L < Serum β-2 Microglobul<strong>in</strong> Level < 5.5 mg / L<br />
(with any Serum Album<strong>in</strong> level)<br />
III Serum β-2 Microglobul<strong>in</strong> Level > 5.5 mg / L<br />
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