IMWG ´14 DIAGNOSTIC CRITERIA TO INITIATE TREATMENT IN NEW.... EHA Library. ESCALANTE BARRIGON F. May 18 2017; 182735

Search Loading

Navbar input

WAIT FOR SUGGESTIONS BY CATEGORY
OR CONTINUE TYPING IN YOUR KEYWORDS

ENTER ONE OR MULTIPLE KEYWORDS &
PRESS THE SEARCH BUTTON
From

To
Search

Favorites
Advanced Minimize

More ▾ Less ▸

Clear

IMWG ´14 DIAGNOSTIC CRITERIA TO INITIATE TREATMENT IN NEW DIAGNOSED MULTIPLE MYELOMA (NDMM): REAL-WORLD STADISTICS

Author(s):

Paola Gonzalez

Belén Ballina

Seila Cerdá

Marta Fuertes

Lavinia Villalobos

Violeta Martínez-Robles

José Antonio Rodríguez-García

Fernando Escalante

(Abstract release date: 05/18/17) EHA Library. ESCALANTE BARRIGON F. 05/18/17; 182735; PB2021

Dr. FERNANDO ESCALANTE BARRIGON
Contributions

PDF Abstract

Abstract

Abstract: PB2021

Type: Publication Only

Background
Diagnostic criteria for Symptomatic Multiple Myeloma (MM) Published in 2003 by the International Myeloma Working Group(IMWG'03) established for the presence of a bone Marrow infiltration by plasma cells (BMPC) in any percentage And / or the presence of a monoclonal component of any amount Along with the presence of signs or symptoms of organ damage (CRAB) attributable to the proliferation of plasma cells.

These criteria have not changed in the last decade until the Recent revision of diagnostic criteria and treatment that IMWG Published by the end of 2014, which proposes an initial Pathologic condition (> 10% BMPC or demonstration of a Plasmacytoma) as a preliminary condition before starting treatment
Due to 'CRAB redefined' and / or the presence of markers of Rapid progression to 'classical-symptomatic' MM criteria.

Aims
There are few information about real-life statistics in NDMM according to new criteria to initiate treatment.

This 2year analysis shows a percentage of patients (22%) who have initiated new treatments superior to those described in the literature

Methods
We have performed a retrospective analysis with all new MM cases diagnosed from Dec-2014 (after new criteria were published) to Feb-2017 (28 months).

55 patients were diagnosed of MM. 26 were male and 29 female. The median age at diagnosis was 74 years (52-87), 11 were under 65 (U65) and 44 were over 65 (O65).

Results
3 were diagnosed after biopsy of plasmacytomas. None of them have Bone Marrow (BM) infiltration but with criteria of MM after PET-CT multitopic involvement.

7 of these NDMM were smoldering MM (sMM). All of then completed initial staging with more sensitive imaging tests than conventional radiology (MRI and / or PET-CT)

2 of these sMM were under 65 years old and were included in a clinical trial. The other 5 were older than 65 and after a median of 16 months of follow-up did not meet criteria in initiate treatment.

Of the 41 patients who started treatment, 10 of them were new criteria, the rest met criteria for classic organic disease (CRAB) Fig1

6 patients were diagnosed after performance of PET-CT (3 of them after plasmacytoma biopsy; initial diagnosis: solitary plasmacytoma), 1 after PET-CT negative but MRI positive, 2 with FLC ratio criterium and the last one with BM Plasmatic Cell (BMPC) >60%, MRI image and FLC criteria.

Although these data are quite different from those reported previously, accurate diagnosis in initial stages may increment the proportion of real-active MM.

We don´t observe increments in incidence rate in these period vs pre´2014 (reported to 22nd EHA abstract)

We observe that the early mortality is decreasing in the last 5 years (from 2013). The effect of early diagnostic may contirbute to get these improvement of survival.

Conclusion
One of the hypotheses for introducing new criteria for initiating treatment was that the initiation of adequate and early treatment may improve the prognosis of patients with symptomatic NDMM.

In an aging population such as the one we present, we believe that these new criteria to initiate treatment can improve the medium- and long-term prognosis of this group of people with few chance to start intensive or a lot of lines of treatment because of increasingly comorbidities by age.

Further follow-up and evaluation of survival comparing the 'classical' group vs new-criteria group are guaranteed to assess if these early treatment will improve survival.

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

Keyword(s): epidemiology