R2-ISS (Second Revision of the International Staging System for Multiple Myeloma)

Stratifies overall-survival risk in newly diagnosed multiple myeloma from ISS stage, LDH, and high-risk cytogenetics into four prognostic groups (R2-ISS I–IV), refining the original ISS and R-ISS.

ISS stage (beta-2 microglobulin / albumin)

Serum LDH above institutional upper limit of normal? (+1.0)

del(17p) by FISH (≥ 50% clonal plasma cells)? (+1.0)

t(4;14) by FISH? (+1.0)

1q21+ (gain ≥ 3 copies or amplification ≥ 4 copies)? (+0.5)