Clinical relevance of high-risk cytogenetic abnormalities and the second revision of the International Staging System (R2-ISS) in patients with multiple myeloma in clinical practice

Mizuguchi, Makiko; Okamoto, Yasunobu; Yagi, Hikaru; Kagawa, Keiichiro; Sekimoto, Etsuko; Shibata, Hironobu; Shigekiyo, Toshio; Ozaki, Shuji

doi:10.1007/s12185-023-03541-x

Int J Hematol

2023

DOI: 10.1007/s12185-023-03541-x

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Clinical relevance of high-risk cytogenetic abnormalities and the second revision of the International Staging System (R2-ISS) in patients with multiple myeloma in clinical practice

Makiko Mizuguchi

Yasunobu Okamoto

Hikaru Yagi

et al.

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Cited by 3 publications

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“…Previous work has evaluated these staging systems in small single-center analyses, such as two single-center reports from China evaluating the performance of MASS in 94 [ 9 ] and 307 patients [ 10 ], respectively. Similar single-center studies have also evaluated the performance of R2-ISS in cohorts from China and Japan [ 11 , 12 ]. An analysis in the United States has validated R2-ISS, but this was in a transplanted cohort, different from our analysis, which was predominantly in a non-transplant cohort [ 13 ].…”

mentioning

confidence: 99%

Performance of newer myeloma staging systems in a contemporary, large patient cohort

Mohyuddin,

Rubinstein,

Kumar

et al. 2024

Blood Cancer J.

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mentioning

confidence: 99%

Performance of newer myeloma staging systems in a contemporary, large patient cohort

Mohyuddin,

Rubinstein,

Kumar

et al. 2024

Blood Cancer J.

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Validation of the second revision of the international staging system (R2-ISS) for overall survival in multiple myeloma in a real-world cohort: an analysis by the Balkan myeloma study group (BMSG)

Kastritis,

Katodritou,

Badelita

et al. 2024

Leukemia & Lymphoma

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Application of R2-ISS risk stratification to patients with multiple myeloma treated with autologous stem cell transplants at UAMS

Guo,

Zhan,

Mery

et al. 2023

Blood Advances

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R2-ISS was published in 2022 and has been validated in several cohorts of myeloma patients. In this study, we investigated a total of 1007 multiple myeloma (MM) patients who received autologous stem cell transplantation (ASCT) between 2001 and 2021. The median age of the patients was 61 years, with a median overall survival (OS) of 91 months and median progression-free survival (PFS) of 66 months. We collected the variables included in the R-ISS and R2-ISS system, as well as additional data such as routine blood markers, bone marrow plasmacytosis, and selected metabolic variables including serum glucose and cholesterol levels. Our analyses demonstrated that all three ISS series systems (ISS, R-ISS, and R2-ISS) exhibited robust discrimination in terms of both OS and PFS among our study cohort. The ISS system effectively stratified patients into three risk groups, while the R-ISS system accurately identified extremely high-risk or low-risk patients. The R2-ISS system further refined risk stratification by dividing patients into four more balanced risk groups. Furthermore, we specifically focused on identifying variables that distinguished patients with OS<3 years and OS>10 years within the low-risk R2-ISS stages (I & II) and high-risk R2-ISS stages (III & IV). Our findings revealed that age and serum glucose levels significantly influenced the classification of patients in the low-risk R2-ISS stage. Additionally, variables such as serum light chain, platelet count, serum glucose, triglyceride levels, age, and the presence of chromosomal 14;16 translocation [t(14;16)] were found to impact high-risk classification.

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Clinical relevance of high-risk cytogenetic abnormalities and the second revision of the International Staging System (R2-ISS) in patients with multiple myeloma in clinical practice

Cited by 3 publications

References 51 publications

Performance of newer myeloma staging systems in a contemporary, large patient cohort

Performance of newer myeloma staging systems in a contemporary, large patient cohort

Validation of the second revision of the international staging system (R2-ISS) for overall survival in multiple myeloma in a real-world cohort: an analysis by the Balkan myeloma study group (BMSG)

Application of R2-ISS risk stratification to patients with multiple myeloma treated with autologous stem cell transplants at UAMS

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