2019
DOI: 10.1182/blood-2019-130092
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Significance of Modified Risk Stratification Msmart 3.0 and Autologous Stem Cell Transplantation for Patients with Newly Diagnosed Multiple Myeloma

Abstract: Background The risk-stratification systems are repeatedly updated in accordance with the emergence of new information about the prognostic impact of anomalies and other factors. The most extensive and modern system in this time is mSMART risk stratification involving many parameters such as genetic anomalies, albumin, beta-2-microglobulin, LDH, Plasma Cell S-phase and GEP levels. It is possible to use risk-adapted treatment programs with or without ASCT. Nevertheless, the role of complex karyoty… Show more

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Cited by 13 publications
(6 citation statements)
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“…However, the impact of CA concurrence varied among different HRCAs, in which concurrence of t(14;16) or del(17p), rather than t(4;14), markedly exacerbated the outcomes of patients with +1q. While these observations support the definition of double‐hit MM described in the mSMART 3.0, 38 they also raise a consideration that it may be important to know which concurrent HRCAs are exactly involved. Interestingly, concurrence of some non‐HRCAs (e.g., del(1p) and del(13q)) might also influence the outcomes of patients with +1q 36,39 .…”
Section: Discussionmentioning
confidence: 57%
“…However, the impact of CA concurrence varied among different HRCAs, in which concurrence of t(14;16) or del(17p), rather than t(4;14), markedly exacerbated the outcomes of patients with +1q. While these observations support the definition of double‐hit MM described in the mSMART 3.0, 38 they also raise a consideration that it may be important to know which concurrent HRCAs are exactly involved. Interestingly, concurrence of some non‐HRCAs (e.g., del(1p) and del(13q)) might also influence the outcomes of patients with +1q 36,39 .…”
Section: Discussionmentioning
confidence: 57%
“…In this context, the international staging system (ISS) was developed to predict the prognosis of MM patients in 2005, 4 which was later updated and named revised ISS (R‐ISS) in 2015 5 . Although the R‐ISS has widely been used as a powerful tool to guide daily practice till present, some considerable limitations (eg, a large proportion of R‐ISS II patients with varied outcomes, not reflecting the significance of 1q gain/amplification and concurrent high‐risk cytogenetic abnormalities [HRCAs]) have been emerging 6–9 . In this context, several new prognostic scoring systems have been reported, 10,11 the most recent of which is the second revision of ISS (R2‐ISS) updated by the European Myeloma Network (EMN) 12 …”
Section: Figurementioning
confidence: 99%
“…5 Although the R-ISS has widely been used as a powerful tool to guide daily practice till present, some considerable limitations (eg, a large proportion of R-ISS II patients with varied outcomes, not reflecting the significance of 1q gain/amplification and concurrent high-risk cytogenetic abnormalities [HRCAs]) have been emerging. [6][7][8][9] In this context, several new prognostic scoring systems have been reported, 10,11 the most recent of which is the second revision of ISS (R2-ISS) updated by the European Myeloma Network (EMN). 12 In the R2-ISS, 12 5 risk variates with the highest impact on both progression-free survival (PFS) and overall survival (OS) were weighted according to their OS impact, including ISS III 1.5, ISS II 1.0, del(17p) 1.0, lactate dehydrogenase high 1.0, t(4;14) 1.0, and 1q+ (either 1q gain or amplification) 0.5.…”
mentioning
confidence: 99%
“…A recent retrospective experience confirmed the greater role of the association of high risk feature rather than a single one, but also the size of high risk clone influenced prognosis [ 26 ]. M-Smart MM risk stratification guideline by Mayo Clinic proposed an innovative concept, with patients possessing two of the high risk genetic abnormalities defined as “double hit” and having any three as “triple hit” MM [ 27 ]. Both phenotypes were considered ultra-high-risk disease characteristics, having observed that they correlated with aggressive clinical presentations, high early mortality and poor outcomes even in real life settings [ 9 , 28 , 29 , 30 ].…”
Section: Improvements In Risk Stratificationmentioning
confidence: 99%