Revised International Staging System for Multiple Myeloma: A Report From International Myeloma Working Group

The clinical outcome of multiple myeloma (MM) is heterogeneous. A simple and reliable tool is needed to stratify patients with MM. We combined the International Staging System (ISS) with chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization after CD138 plasma cell p...

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Veröffentlicht in:Journal of clinical oncology Jg. 33; H. 26; S. 2863
Hauptverfasser: Palumbo, Antonio, Avet-Loiseau, Hervé, Oliva, Stefania, Lokhorst, Henk M, Goldschmidt, Hartmut, Rosinol, Laura, Richardson, Paul, Caltagirone, Simona, Lahuerta, Juan José, Facon, Thierry, Bringhen, Sara, Gay, Francesca, Attal, Michel, Passera, Roberto, Spencer, Andrew, Offidani, Massimo, Kumar, Shaji, Musto, Pellegrino, Lonial, Sagar, Petrucci, Maria T, Orlowski, Robert Z, Zamagni, Elena, Morgan, Gareth, Dimopoulos, Meletios A, Durie, Brian G M, Anderson, Kenneth C, Sonneveld, Pieter, San Miguel, Jésus, Cavo, Michele, Rajkumar, S Vincent, Moreau, Philippe
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 10.09.2015
Schlagworte:
Adolescent
Adult
Aged
Aged, 80 and over
Chromosome Aberrations
Female
Humans
In Situ Hybridization, Fluorescence
L-Lactate Dehydrogenase - blood
Male
Middle Aged
Multiple Myeloma - genetics
Multiple Myeloma - mortality
Multiple Myeloma - pathology
Neoplasm Staging
ISSN:1527-7755, 1527-7755
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Zusammenfassung:The clinical outcome of multiple myeloma (MM) is heterogeneous. A simple and reliable tool is needed to stratify patients with MM. We combined the International Staging System (ISS) with chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization after CD138 plasma cell purification and serum lactate dehydrogenase (LDH) to evaluate their prognostic value in newly diagnosed MM (NDMM). Clinical and laboratory data from 4,445 patients with NDMM enrolled onto 11 international trials were pooled together. The K-adaptive partitioning algorithm was used to define the most appropriate subgroups with homogeneous survival. ISS, CA, and LDH data were simultaneously available in 3,060 of 4,445 patients. We defined the following three groups: revised ISS (R-ISS) I (n = 871), including ISS stage I (serum β2-microglobulin level < 3.5 mg/L and serum albumin level ≥ 3.5 g/dL), no high-risk CA [del(17p) and/or t(4;14) and/or t(14;16)], and normal LDH level (less than the upper limit of normal range); R-ISS III (n = 295), including ISS stage III (serum β2-microglobulin level > 5.5 mg/L) and high-risk CA or high LDH level; and R-ISS II (n = 1,894), including all the other possible combinations. At a median follow-up of 46 months, the 5-year OS rate was 82% in the R-ISS I, 62% in the R-ISS II, and 40% in the R-ISS III groups; the 5-year PFS rates were 55%, 36%, and 24%, respectively. The R-ISS is a simple and powerful prognostic staging system, and we recommend its use in future clinical studies to stratify patients with NDMM effectively with respect to the relative risk to their survival.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:1527-7755
1527-7755
DOI:10.1200/JCO.2015.61.2267