Evaluation of Revised International Staging System (R-ISS) for transplant-eligible multiple myeloma patients

González-Calle, Verónica; Slack, A.; Keane, Niamh; Luft, Susan; Pearce, Kathryn E.; Ketterling, Rhett P.; Jain, Tania; Sintosebastian, Chirackal; Reeder, Craig B.; Mıkhael, Joseph; Noël, Pierre; Mayo, Angela; Adams, Roberta H.; Ahmann, Gregory; Braggio, Esteban; Stewart, A. Keith; Bergsagel, P. Leif; Wier, Scott A. Van; Fonseca, Rafaël

doi:10.1007/s00277-018-3316-7

Cited by 28 publications

(21 citation statements)

References 32 publications

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“…The International Myeloma Working Group (IMWG) 12 criteria was used for the diagnosis of MM and the Revised International Staging System (R-ISS) 13 for its staging. All patients received bortezomib-based therapy that included bortezomib/cyclophosphamide/ dexamethasone for at least 3 months.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Value of CD56 Expression in Multiple Myeloma

Khallaf

Yousof

Ahmed

et al. 2020

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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Background: Understanding the prognostic markers of multiple myeloma (MM) helps in optimizing therapeutic approaches. CD56 is frequently expressed by malignant plasma cells and its use as a prognostic marker in MM is promising. Aim: To evaluate prognostic value of CD56 expression in patients with MM. Methods: This study included 50 newly diagnosed patients with MM. Bone marrow samples were analyzed for CD56 expression by flow cytometry. All patients received bortezomib-based therapy for at least 3-4 months. Results: The median age of patients was 52 years (range 32-75) and 54% of them were males. The stage according to the International Staging System was I in 15 (30%) patients, II in 18 (36%) and III in 17 (34%). CD56 positivity was detected in 84% of enrolled patients. Multivariate analysis revealed that the lack of CD56 expression was an independent predictor of worse overall survival (HR = 4.31 [95% Confidence Interval: 1.23 -15.13], p = 0.002). Conclusion:The present study suggests that CD56 negativity is associated with poor prognosis in patients with MM and that its incorporation in the risk panel of MM may be considered. Further studies with larger sample size to validate its prognostic value are needed.

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Section: Methodsmentioning

confidence: 99%

Prognostic Value of CD56 Expression in Multiple Myeloma

Khallaf

Yousof

Ahmed

et al. 2020

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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“…55 Between 10% and 18% of patients are classified as R-ISS III. [55][56][57][58] In this system, each feature contributes equally to the risk group determination. As more data become available and the understanding of how these features reflect myeloma biology increases, it can be envisaged that staging systems will be refined and features will be weighted.…”

Section: Presence Of More Than One Adverse Cytogenetic Lesionmentioning

confidence: 99%

Toward personalized treatment in multiple myeloma based on molecular characteristics

Pawlyn

Davies

2019

Blood

164

119

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To date, the choice of therapy for an individual multiple myeloma patient has been based on clinical factors such as age and comorbidities. The widespread evolution, validation, and clinical utilization of molecular technologies, such as fluorescence in situ hybridization and next-generation sequencing has enabled the identification of a number of prognostic and predictive biomarkers for progression-free survival, overall survival, and treatment response. In this review, we argue that in order to continue to improve myeloma patient outcomes incorporating such biomarkers into the routine diagnostic workup of patients will allow for the use of personalized, biologically based treatments.

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“…The R-ISS stratifies patients into homogeneous survival subgroups by classifying patients with stage I and a poor prognosis, and patients with stage III and a better prognosis into stage II. Therefore, patients with R-ISS stage I and III had more homogenous survival outcomes, whereas patients with stage II were markedly increased and had heterogeneous survival outcomes [29,30]. In this study, no significant difference in survival was observed according to EASIX in R-ISS I or III, but patients with high EASIX scores had significantly inferior survival than those with low EASIX.…”

Section: Discussionmentioning

confidence: 48%

Endothelial activation and stress index (EASIX) is a reliable predictor for overall survival in patients with multiple myeloma

et al. 2020

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Background: Recently, the endothelial Activation and Stress Index (EASIX) score has been reported to predict overall survival (OS) after allogeneic stem cell transplantation. This study evaluated the prognostic role of EASIX score in patients with newly diagnosed multiple myeloma (MM). Methods: This retrospective study analyzed the records of 1177 patients with newly diagnosed MM between February 2003 and December 2017 from three institutions in the Republic of Korea. Serum lactate dehydrogenase (LDH), creatinine, and platelet count at diagnosis were measured in all included patients. EASIX scores were calculated using the formula-LDH (U/L) × Creatinine (mg/dL) / platelet count (10 9 /L) and were evaluated based on log2 transformed values. Results: The median age of patients was 63 years (range, 22-92), and 495 patients (42.1%) underwent autologous stem cell transplantation (ASCT). The median log2 EASIX score at diagnosis was 1.1 (IQR 0.3-2.3). Using maximally selected log-rank statistics, the optimal EASIX cutoff value for OS was 1.87 on the log2 scale (95% CI 0.562-0.619, p < 0.001). After median follow-up for 50.0 months (range, 0.3-184.1), the median OS was 58.2 months (95% CI 53.644-62.674). Overall, 372 patients (31.6%) showed high EASIX scores at diagnosis, and had significantly inferior OS compared to those with low EASIX (log2 EASIX ≤1.87) (39.1 months vs. 67.2 months, p < 0.001). In multivariate Cox analysis, high EASIX was significantly associated with poor OS (HR 1.444, 95% CI 1.170-1.780, p = 0.001). In the subgroup analysis of patients who underwent ASCT, patients with high EASIX showed significantly inferior OS compared to those with low EASIX (52.8 months vs. 87.0 months, p < 0.001). In addition, in each group of ISS I, II, and III, high EASIX was associated with significantly inferior OS (ISS 1, 45.2 months vs. 76.0 months, p = 0.001; ISS 2, 42.3 months vs. 66.5 months, p = 0.002; ISS 3, 36.8 months vs. 55.1 months, p = 0.001). Conclusion: EASIX score at diagnosis is a simple and strong predictor for OS in patients with newly diagnosed MM.

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Evaluation of Revised International Staging System (R-ISS) for transplant-eligible multiple myeloma patients

Cited by 28 publications

References 32 publications

Prognostic Value of CD56 Expression in Multiple Myeloma

Prognostic Value of CD56 Expression in Multiple Myeloma

Toward personalized treatment in multiple myeloma based on molecular characteristics

Endothelial activation and stress index (EASIX) is a reliable predictor for overall survival in patients with multiple myeloma

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