TY - JOUR
T1 - Revised international staging system for multiple myeloma
T2 - A report from international myeloma working group
AU - Palumbo, Antonio
AU - Avet-Loiseau, Hervé
AU - Oliva, Stefania
AU - Lokhorst, Henk M.
AU - Goldschmidt, Hartmut
AU - Rosinol, Laura
AU - Richardson, Paul
AU - Caltagirone, Simona
AU - Lahuerta, Juan José
AU - Facon, Thierry
AU - Bringhen, Sara
AU - Gay, Francesca
AU - Attal, Michel
AU - Passera, Roberto
AU - Spencer, Andrew
AU - Offidani, Massimo
AU - Kumar, Shaji
AU - Musto, Pellegrino
AU - Lonial, Sagar
AU - Petrucci, Maria T.
AU - Orlowski, Robert Z.
AU - Zamagni, Elena
AU - Morgan, Gareth
AU - Dimopoulos, Meletios A.
AU - Durie, Brian G.M.
AU - Anderson, Kenneth C.
AU - Sonneveld, Pieter
AU - Miguel, Jésus San
AU - Cavo, Michele
AU - Rajkumar, S. Vincent
AU - Moreau, Philippe
N1 - Publisher Copyright:
© 2015 American Society of Clinical Oncology. All rights reserved.
PY - 2015
Y1 - 2015
N2 - Purpose: 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). Patients and Methods: 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. Results: 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. Conclusion: 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.
AB - Purpose: 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). Patients and Methods: 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. Results: 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. Conclusion: 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.
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U2 - 10.1200/JCO.2015.61.2267
DO - 10.1200/JCO.2015.61.2267
M3 - Article
C2 - 26240224
AN - SCOPUS:84951020021
SN - 0732-183X
VL - 33
SP - 2863
EP - 2869
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 26
ER -