PROGNOSTIC SIGNIFICANCE OF THE REVISED INTERNATIONAL STAGING SYSTEM IN MULTIPLE MYELOMA
(Abstract release date: 05/19/16)
EHA Library. Bila J. 06/09/16; 132867; E1318
Dr. Jelena Bila
Contributions
Contributions
Abstract
Abstract: E1318
Type: Eposter Presentation
Background
New prognostic markers are currently in the focus of investigation in order to personalize treatment approach in multiple myeloma (MM).
Aims
The aim of this study was to analyze the prognostic significance of the newest Revised International Staging System (R-ISS) in MM patients ineligible for autologous stem cell transplantation (ASCT).
Methods
A total of 92 newly diagnosed MM patients (median age 67 years, range 35-80 years; 44 male/48 female) were analyzed in the study, with following distribution: IgG myeloma had 55 patients (59.8%), IgA 18 (19.6%), light chains 16 (17.4%), and IgD 2 patients (2.2%). According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 68 patients (73.9%), II in 18 (19.6%), and symptomatic I CS in 6 (6.5%) patients. The ISS score 1 had 24 (26.1%) patients, 28 (30.4%) ISS 2, and 40 patients (43.5%) had ISS 3. Elevated LDH level was present in 18/92 patients (19.6%). High risk chromosomal abnormalities (CA, iFISH): t(4; 14), del(17p), or t(14;16) were detected in 14 patients (15.2%). Renal impairment existed in 16 patients (17.4%). New R-ISS scoring system based on LDH level, ISS and CA defines three risk categories with the following distribution: RSS I 21 patients (22.8%), II 63 (68.5%), and III 8 patients (8.7%). Renal impairment existed in 16 patients (17.4%). Thalidomide based combinations were applied in 77 patients (83.7%) while 15 patients (16.3%) were treated with bortezomib based combinations. The patients were ASCT ineligible due to the age, high comorbidity index, progressive disease or personal attitude.
Results
Overall treatment response (CR/VGPR/PR/MR, IMWG criteria) was achieved in 77 patients (83.7%). In the group treated with thalidomide based combinations, 65 patients (84.5%) achieved favourable treatment response, in comparison to the 12/15 patients treated with bortezomib based combinations. According to the R-ISS score, overall treatment response was achieved in 20/21 patients (95.2%) with R-ISS I; in 54/63 (85.7%) with R-ISS II; and in 3/8 (37.5%) with R-ISS III. There wasn’t observed correlation between R-ISS and therapy response neither in the thalidomide treated group (p=0.47) nor in the bortezomib treated group (p=0.149). The median follow up of analyzed group was 27 months (range 4-42 months). The components of R-ISS score as: ISS, elevated LDH and the presence of high risk CA, was found to be the factors of prognostic significance on PFS (Log Rank=4.19, p=0.041; Log Rank=12.23, p=0.001; Log Rank=4.94, p=0.026, respectively) and OS (Log Rank=4.34, p=0.04; Log Rank=13.34, p=0.001; Log Rank=5.08, p=0.024, respectively). In analyzed group, age didn’t have impact on the PFS or OS (p˃0.05). The R-ISS was highly statistically relevant regarding PFS (Log Rank=10.79, p=0.005) and OS (Log Rank=14.41, p= 0.001). Similarly, in the group treated with thalidomide based combinations, the R-ISS retained prognostic significance on OS (Log Rank=17.54, p=0.0001) and PFS (Log Rank=12.56, p=0.002). Cox regression analysis confirmed that R-ISS was the most important prognostic parameter that influenced PFS in thalidomide treated patients (HR, 5.1; 95% CI, 2.02-12.85; p=0.001).
Conclusion
Incorporating the findings of molecular genetics along with parameters of disease activity, the R-ISS score represents currently most sensitive prognostic tool in multiple myeloma with consequent implications to personalized treatment approach.
Session topic: E-poster
Keyword(s): Multiple myeloma, Prognosis
Type: Eposter Presentation
Background
New prognostic markers are currently in the focus of investigation in order to personalize treatment approach in multiple myeloma (MM).
Aims
The aim of this study was to analyze the prognostic significance of the newest Revised International Staging System (R-ISS) in MM patients ineligible for autologous stem cell transplantation (ASCT).
Methods
A total of 92 newly diagnosed MM patients (median age 67 years, range 35-80 years; 44 male/48 female) were analyzed in the study, with following distribution: IgG myeloma had 55 patients (59.8%), IgA 18 (19.6%), light chains 16 (17.4%), and IgD 2 patients (2.2%). According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 68 patients (73.9%), II in 18 (19.6%), and symptomatic I CS in 6 (6.5%) patients. The ISS score 1 had 24 (26.1%) patients, 28 (30.4%) ISS 2, and 40 patients (43.5%) had ISS 3. Elevated LDH level was present in 18/92 patients (19.6%). High risk chromosomal abnormalities (CA, iFISH): t(4; 14), del(17p), or t(14;16) were detected in 14 patients (15.2%). Renal impairment existed in 16 patients (17.4%). New R-ISS scoring system based on LDH level, ISS and CA defines three risk categories with the following distribution: RSS I 21 patients (22.8%), II 63 (68.5%), and III 8 patients (8.7%). Renal impairment existed in 16 patients (17.4%). Thalidomide based combinations were applied in 77 patients (83.7%) while 15 patients (16.3%) were treated with bortezomib based combinations. The patients were ASCT ineligible due to the age, high comorbidity index, progressive disease or personal attitude.
Results
Overall treatment response (CR/VGPR/PR/MR, IMWG criteria) was achieved in 77 patients (83.7%). In the group treated with thalidomide based combinations, 65 patients (84.5%) achieved favourable treatment response, in comparison to the 12/15 patients treated with bortezomib based combinations. According to the R-ISS score, overall treatment response was achieved in 20/21 patients (95.2%) with R-ISS I; in 54/63 (85.7%) with R-ISS II; and in 3/8 (37.5%) with R-ISS III. There wasn’t observed correlation between R-ISS and therapy response neither in the thalidomide treated group (p=0.47) nor in the bortezomib treated group (p=0.149). The median follow up of analyzed group was 27 months (range 4-42 months). The components of R-ISS score as: ISS, elevated LDH and the presence of high risk CA, was found to be the factors of prognostic significance on PFS (Log Rank=4.19, p=0.041; Log Rank=12.23, p=0.001; Log Rank=4.94, p=0.026, respectively) and OS (Log Rank=4.34, p=0.04; Log Rank=13.34, p=0.001; Log Rank=5.08, p=0.024, respectively). In analyzed group, age didn’t have impact on the PFS or OS (p˃0.05). The R-ISS was highly statistically relevant regarding PFS (Log Rank=10.79, p=0.005) and OS (Log Rank=14.41, p= 0.001). Similarly, in the group treated with thalidomide based combinations, the R-ISS retained prognostic significance on OS (Log Rank=17.54, p=0.0001) and PFS (Log Rank=12.56, p=0.002). Cox regression analysis confirmed that R-ISS was the most important prognostic parameter that influenced PFS in thalidomide treated patients (HR, 5.1; 95% CI, 2.02-12.85; p=0.001).
Conclusion
Incorporating the findings of molecular genetics along with parameters of disease activity, the R-ISS score represents currently most sensitive prognostic tool in multiple myeloma with consequent implications to personalized treatment approach.
Session topic: E-poster
Keyword(s): Multiple myeloma, Prognosis
Abstract: E1318
Type: Eposter Presentation
Background
New prognostic markers are currently in the focus of investigation in order to personalize treatment approach in multiple myeloma (MM).
Aims
The aim of this study was to analyze the prognostic significance of the newest Revised International Staging System (R-ISS) in MM patients ineligible for autologous stem cell transplantation (ASCT).
Methods
A total of 92 newly diagnosed MM patients (median age 67 years, range 35-80 years; 44 male/48 female) were analyzed in the study, with following distribution: IgG myeloma had 55 patients (59.8%), IgA 18 (19.6%), light chains 16 (17.4%), and IgD 2 patients (2.2%). According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 68 patients (73.9%), II in 18 (19.6%), and symptomatic I CS in 6 (6.5%) patients. The ISS score 1 had 24 (26.1%) patients, 28 (30.4%) ISS 2, and 40 patients (43.5%) had ISS 3. Elevated LDH level was present in 18/92 patients (19.6%). High risk chromosomal abnormalities (CA, iFISH): t(4; 14), del(17p), or t(14;16) were detected in 14 patients (15.2%). Renal impairment existed in 16 patients (17.4%). New R-ISS scoring system based on LDH level, ISS and CA defines three risk categories with the following distribution: RSS I 21 patients (22.8%), II 63 (68.5%), and III 8 patients (8.7%). Renal impairment existed in 16 patients (17.4%). Thalidomide based combinations were applied in 77 patients (83.7%) while 15 patients (16.3%) were treated with bortezomib based combinations. The patients were ASCT ineligible due to the age, high comorbidity index, progressive disease or personal attitude.
Results
Overall treatment response (CR/VGPR/PR/MR, IMWG criteria) was achieved in 77 patients (83.7%). In the group treated with thalidomide based combinations, 65 patients (84.5%) achieved favourable treatment response, in comparison to the 12/15 patients treated with bortezomib based combinations. According to the R-ISS score, overall treatment response was achieved in 20/21 patients (95.2%) with R-ISS I; in 54/63 (85.7%) with R-ISS II; and in 3/8 (37.5%) with R-ISS III. There wasn’t observed correlation between R-ISS and therapy response neither in the thalidomide treated group (p=0.47) nor in the bortezomib treated group (p=0.149). The median follow up of analyzed group was 27 months (range 4-42 months). The components of R-ISS score as: ISS, elevated LDH and the presence of high risk CA, was found to be the factors of prognostic significance on PFS (Log Rank=4.19, p=0.041; Log Rank=12.23, p=0.001; Log Rank=4.94, p=0.026, respectively) and OS (Log Rank=4.34, p=0.04; Log Rank=13.34, p=0.001; Log Rank=5.08, p=0.024, respectively). In analyzed group, age didn’t have impact on the PFS or OS (p˃0.05). The R-ISS was highly statistically relevant regarding PFS (Log Rank=10.79, p=0.005) and OS (Log Rank=14.41, p= 0.001). Similarly, in the group treated with thalidomide based combinations, the R-ISS retained prognostic significance on OS (Log Rank=17.54, p=0.0001) and PFS (Log Rank=12.56, p=0.002). Cox regression analysis confirmed that R-ISS was the most important prognostic parameter that influenced PFS in thalidomide treated patients (HR, 5.1; 95% CI, 2.02-12.85; p=0.001).
Conclusion
Incorporating the findings of molecular genetics along with parameters of disease activity, the R-ISS score represents currently most sensitive prognostic tool in multiple myeloma with consequent implications to personalized treatment approach.
Session topic: E-poster
Keyword(s): Multiple myeloma, Prognosis
Type: Eposter Presentation
Background
New prognostic markers are currently in the focus of investigation in order to personalize treatment approach in multiple myeloma (MM).
Aims
The aim of this study was to analyze the prognostic significance of the newest Revised International Staging System (R-ISS) in MM patients ineligible for autologous stem cell transplantation (ASCT).
Methods
A total of 92 newly diagnosed MM patients (median age 67 years, range 35-80 years; 44 male/48 female) were analyzed in the study, with following distribution: IgG myeloma had 55 patients (59.8%), IgA 18 (19.6%), light chains 16 (17.4%), and IgD 2 patients (2.2%). According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 68 patients (73.9%), II in 18 (19.6%), and symptomatic I CS in 6 (6.5%) patients. The ISS score 1 had 24 (26.1%) patients, 28 (30.4%) ISS 2, and 40 patients (43.5%) had ISS 3. Elevated LDH level was present in 18/92 patients (19.6%). High risk chromosomal abnormalities (CA, iFISH): t(4; 14), del(17p), or t(14;16) were detected in 14 patients (15.2%). Renal impairment existed in 16 patients (17.4%). New R-ISS scoring system based on LDH level, ISS and CA defines three risk categories with the following distribution: RSS I 21 patients (22.8%), II 63 (68.5%), and III 8 patients (8.7%). Renal impairment existed in 16 patients (17.4%). Thalidomide based combinations were applied in 77 patients (83.7%) while 15 patients (16.3%) were treated with bortezomib based combinations. The patients were ASCT ineligible due to the age, high comorbidity index, progressive disease or personal attitude.
Results
Overall treatment response (CR/VGPR/PR/MR, IMWG criteria) was achieved in 77 patients (83.7%). In the group treated with thalidomide based combinations, 65 patients (84.5%) achieved favourable treatment response, in comparison to the 12/15 patients treated with bortezomib based combinations. According to the R-ISS score, overall treatment response was achieved in 20/21 patients (95.2%) with R-ISS I; in 54/63 (85.7%) with R-ISS II; and in 3/8 (37.5%) with R-ISS III. There wasn’t observed correlation between R-ISS and therapy response neither in the thalidomide treated group (p=0.47) nor in the bortezomib treated group (p=0.149). The median follow up of analyzed group was 27 months (range 4-42 months). The components of R-ISS score as: ISS, elevated LDH and the presence of high risk CA, was found to be the factors of prognostic significance on PFS (Log Rank=4.19, p=0.041; Log Rank=12.23, p=0.001; Log Rank=4.94, p=0.026, respectively) and OS (Log Rank=4.34, p=0.04; Log Rank=13.34, p=0.001; Log Rank=5.08, p=0.024, respectively). In analyzed group, age didn’t have impact on the PFS or OS (p˃0.05). The R-ISS was highly statistically relevant regarding PFS (Log Rank=10.79, p=0.005) and OS (Log Rank=14.41, p= 0.001). Similarly, in the group treated with thalidomide based combinations, the R-ISS retained prognostic significance on OS (Log Rank=17.54, p=0.0001) and PFS (Log Rank=12.56, p=0.002). Cox regression analysis confirmed that R-ISS was the most important prognostic parameter that influenced PFS in thalidomide treated patients (HR, 5.1; 95% CI, 2.02-12.85; p=0.001).
Conclusion
Incorporating the findings of molecular genetics along with parameters of disease activity, the R-ISS score represents currently most sensitive prognostic tool in multiple myeloma with consequent implications to personalized treatment approach.
Session topic: E-poster
Keyword(s): Multiple myeloma, Prognosis
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