revised_iss_multiple_myeloma: Revised International Staging System (R-ISS) for Multiple...

In cliot: Clinical Indices and Outcomes Tools

Revised International Staging System (R-ISS) for Multiple Myeloma

Description

Calculates the Revised International Staging System (R-ISS) for multiple myeloma. This system combines the original ISS (serum beta-2 microglobulin and albumin) with chromosomal abnormalities (CA) detected by iFISH and serum lactate dehydrogenase (LDH) levels to improve prognostic stratification.

Usage

revised_iss_multiple_myeloma(beta2_microglobulin, albumin, ldh_elevated,
                             high_risk_chromosomal_abnormalities)

Arguments

beta2_microglobulin	Numeric. Serum Beta-2 Microglobulin level in mg/L.
albumin	Numeric. Serum Albumin level in g/dL.
ldh_elevated	Numeric (0 or 1). Is serum LDH greater than the upper limit of normal? (1 = Yes).
high_risk_chromosomal_abnormalities	Numeric (0 or 1). Presence of high-risk chromosomal abnormalities by iFISH (del(17p), t(4;14), or t(14;16)). (1 = Yes).

Details

Staging Criteria:

• R-ISS I: ISS Stage I (B2M < 3.5 and Alb >= 3.5) AND No High Risk CA AND Normal LDH.

• R-ISS III: ISS Stage III (B2M >= 5.5) AND (High Risk CA OR High LDH).

• R-ISS II: Not R-ISS I or III.

Value

A list containing:

R_ISS_Stage	The calculated R-ISS Stage (I, II, or III).
ISS_Stage_Calculated	The underlying standard ISS stage.
Median_Overall_Survival	Estimated median overall survival.
Five_Year_Survival	Estimated 5-year overall survival rate.

References

Palumbo A, Avet-Loiseau H, Oliva S, et al. Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group. J Clin Oncol. 2015;33(26):2863-2869. doi:10.1200/JCO.2015.61.2267

Examples

# Example 1: R-ISS Stage I
# B2M 2.0, Alb 4.0 (ISS I), Normal LDH, No High Risk CA
revised_iss_multiple_myeloma(2.0, 4.0, 0, 0)

# Example 2: R-ISS Stage III
# B2M 6.0 (ISS III), High LDH
revised_iss_multiple_myeloma(6.0, 3.0, 1, 0)

# Example 3: R-ISS Stage II
# B2M 2.0, Alb 4.0 (ISS I), but High LDH (Disqualifies R-ISS I)
revised_iss_multiple_myeloma(2.0, 4.0, 1, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.