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RETROSPECTIVE ANALYSIS OF 121 MULTIPLE MYELOMA PATIENTS USING THE R-ISS PROGNOSTIC STAGING SYSTEM AND RESPONSE TO FIRST LINE OF TREATMENT
Author(s):
Rasha Ghonema
,
Rasha Ghonema
Affiliations:
Hematology,Kuwait cancer control centre,Kuwait,Kuwait
Salem AlShemmari
,
Salem AlShemmari
Affiliations:
Hematology,Kuwait cancer control centre,Kuwait,Kuwait
Ramesh Pandita
,
Ramesh Pandita
Affiliations:
Hematology,Kuwait cancer control centre,Kuwait,Kuwait
Mahmoud Hasaneen
,
Mahmoud Hasaneen
Affiliations:
Hematology,Kuwait cancer control centre,Kuwait,Kuwait
Mohammad Al-Drees
Mohammad Al-Drees
Affiliations:
Hematology,Kuwait cancer control centre,Kuwait,Kuwait
(Abstract release date: 05/18/17) EHA Library. Ghonema R. 05/18/17; 182686; PB1972
Rasha Ghonema
Rasha Ghonema
Contributions
PDF Abstract
Abstract

Abstract: PB1972

Type: Publication Only

Background
The International Myeloma Working Group has developed the R-ISS (Revised International Staging System) as a simple and powerful prognostic staging system. We collected the LDH level and the cytogenetics of a group of patients and studied the difference between the ISS (International Staging System) and the R-ISS (Revised International Staging System) for those patients.

Aims
To evaluate and compare between the ISS and the R-ISS for a group of patients treated in Kuwait Cancer Control Centre

Methods
A retrospective analysis of the data collected from 121 patients registered as multiple myeloma from 2011-2015, 5 of the patients presented to our centre after initial work up and starting the treatment abroad. The patients were categorised according to age, gender, ISS stage, R-ISS stage, first line therapy and response.

Results

We recognised increase of the number of the yearly diagnosed patients with myeloma 2.48% of patients the actual date of diagnosis was before 2011 but they presented to our centre from2011-2015
Median age of patients at presentation is 56 years old, 3.33% between30-40 years old, 18.33% between 40-50 years old, 35% between 50-60 years old, 31.67 % between 60-70 years old and 11.67% between 70-80 years old.
Male to female ratio 1.75:1
ISS stage
% of patients
RISS stage
% of patients
Stage I
14%
Stage I
10%
Stage II
31%
Stage II
26%
Stage III
47%
Stage III
56%
Plasmacytoma
2%
Plasmacytoma
2%
MGUS
2%
MGUS
2%
Unknown stage(diagnosed outside our centre)
4%
Unknown stage(diagnosed outside our centre)
4%
According to ISS stage patients were categorised into14% stage I,31% stageII,47% stage III.Restaging using the RISS revealed10% stage I, 26% stageII, 56%stage III.Almost half of our patients are diagnosed in the third stage, and more patients were shifted from stage I or II were categorised in the third stage due to either high LDH level, high cytogenetic risk or even both.
First line treatment 55% of the patients received Bortezomib based triple therapy, 22% received CTD(Cyclophosphamide, Thalidomide, Dexamethasone),7%RD(Lenalidomide,Dexamethasone), 3% CyBorD(Cyclophosphamide,Bortezomib, Dexamethasone), 3%RV(Lenalidomide, Bortezomib),2%Thal-Dex (Thalidomide, Dexamethasone), 2%RT(local Radiotherapy), 2%WatchfulWait,1%MP (Melphalan, Prednisone)and 3% refused for treatment and lost follow up.

Conclusion
Applying the RISS system to myeloma patients is very effective and easy method to categorise myeloma patients, a significant number of patients in Kuwait are diagnosed as stage III, with median age of 56 years although the use of novel therapies shows excellent response to most of them.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Staging, Multiple Myeloma, Age

Abstract: PB1972

Type: Publication Only

Background
The International Myeloma Working Group has developed the R-ISS (Revised International Staging System) as a simple and powerful prognostic staging system. We collected the LDH level and the cytogenetics of a group of patients and studied the difference between the ISS (International Staging System) and the R-ISS (Revised International Staging System) for those patients.

Aims
To evaluate and compare between the ISS and the R-ISS for a group of patients treated in Kuwait Cancer Control Centre

Methods
A retrospective analysis of the data collected from 121 patients registered as multiple myeloma from 2011-2015, 5 of the patients presented to our centre after initial work up and starting the treatment abroad. The patients were categorised according to age, gender, ISS stage, R-ISS stage, first line therapy and response.

Results

We recognised increase of the number of the yearly diagnosed patients with myeloma 2.48% of patients the actual date of diagnosis was before 2011 but they presented to our centre from2011-2015
Median age of patients at presentation is 56 years old, 3.33% between30-40 years old, 18.33% between 40-50 years old, 35% between 50-60 years old, 31.67 % between 60-70 years old and 11.67% between 70-80 years old.
Male to female ratio 1.75:1
ISS stage
% of patients
RISS stage
% of patients
Stage I
14%
Stage I
10%
Stage II
31%
Stage II
26%
Stage III
47%
Stage III
56%
Plasmacytoma
2%
Plasmacytoma
2%
MGUS
2%
MGUS
2%
Unknown stage(diagnosed outside our centre)
4%
Unknown stage(diagnosed outside our centre)
4%
According to ISS stage patients were categorised into14% stage I,31% stageII,47% stage III.Restaging using the RISS revealed10% stage I, 26% stageII, 56%stage III.Almost half of our patients are diagnosed in the third stage, and more patients were shifted from stage I or II were categorised in the third stage due to either high LDH level, high cytogenetic risk or even both.
First line treatment 55% of the patients received Bortezomib based triple therapy, 22% received CTD(Cyclophosphamide, Thalidomide, Dexamethasone),7%RD(Lenalidomide,Dexamethasone), 3% CyBorD(Cyclophosphamide,Bortezomib, Dexamethasone), 3%RV(Lenalidomide, Bortezomib),2%Thal-Dex (Thalidomide, Dexamethasone), 2%RT(local Radiotherapy), 2%WatchfulWait,1%MP (Melphalan, Prednisone)and 3% refused for treatment and lost follow up.

Conclusion
Applying the RISS system to myeloma patients is very effective and easy method to categorise myeloma patients, a significant number of patients in Kuwait are diagnosed as stage III, with median age of 56 years although the use of novel therapies shows excellent response to most of them.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Staging, Multiple Myeloma, Age

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