Contributions
Abstract: PB2220
Type: Publication Only
Background
In attempt to define different prognostic groups, with a final goal to personalize optimal approach in treatment of patients with multiple myeloma (MM), Revised International Staging System (R-ISS) was established.
Aims
The aim of study was to analyze the prognostic significance of the R-ISS score in MM patients eligible for autologous stem cell transplantation (ASCT).
Methods
A total of 112 newly diagnosed MM patients (median age 54 years, range 22-65years; 63 male/49 female), were analyzed in the study, with following distribution: IgG myeloma had 72 patients (64.2%), IgA 19 (17.0%), IgD 3 patients (2.7%), light chains 14 (12.5%), and non-secretory 4 (3.6%), and. According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 87 patients (77.7%), II in 15 (13.4%), and symptomatic I CS in 10 (8.9%) patients. The ISS score 1 had 56 (50.0%) patients, 21 (18.7%) ISS 2, and 35 patients (31.3%) had ISS 3. Renal impairment existed in 14 patients (12.5%). According to the R-ISS score, the distribution was as follows: RSS I 58 patients (51.8%), II 39 (34.8%), and III 15 patients (13.4%). Patients were treated with induction therapy based on triple combinations with thalidomide and/or bortezomib, followed with high-doses of Melphalan (HDT, 200mg/m2), and supported with ASCT.
Results
The overall treatment response (CR/VGPR/PR, IMWG criteria), analyzed on +100. day after HDT+ASCT, was achieved in 108 patients (96.4%). According to the R-ISS score, overall treatment response was achieved in all of 58 patients with R-ISS I; in 38/39 (97.4%) with R-ISS II; and in 32/35 (91.4%) with R-ISS III. The median follow up of analyzed group was 52 months (range 12-143 months). The R-ISS was highly statistically relevant regarding both EFS (Log Rank=13.729, p=0.001) and OS (Log Rank=10.486, p= 0.001). Cox regression analysis confirmed that R-ISS was the most important prognostic parameter that influenced OS. (95% CI, 1.056-7.120; p=0.038).
Conclusion
The R-ISS score is highly significant prognostic factor in transplant eligible myeloma patients. It represents currently most sensitive prognostic tool in multiple myeloma with consequent implications to personalized treatment approach.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, prognosis, Treatment
Abstract: PB2220
Type: Publication Only
Background
In attempt to define different prognostic groups, with a final goal to personalize optimal approach in treatment of patients with multiple myeloma (MM), Revised International Staging System (R-ISS) was established.
Aims
The aim of study was to analyze the prognostic significance of the R-ISS score in MM patients eligible for autologous stem cell transplantation (ASCT).
Methods
A total of 112 newly diagnosed MM patients (median age 54 years, range 22-65years; 63 male/49 female), were analyzed in the study, with following distribution: IgG myeloma had 72 patients (64.2%), IgA 19 (17.0%), IgD 3 patients (2.7%), light chains 14 (12.5%), and non-secretory 4 (3.6%), and. According to the clinical stage (CS, Durie&Salmon), advanced III CS was found in 87 patients (77.7%), II in 15 (13.4%), and symptomatic I CS in 10 (8.9%) patients. The ISS score 1 had 56 (50.0%) patients, 21 (18.7%) ISS 2, and 35 patients (31.3%) had ISS 3. Renal impairment existed in 14 patients (12.5%). According to the R-ISS score, the distribution was as follows: RSS I 58 patients (51.8%), II 39 (34.8%), and III 15 patients (13.4%). Patients were treated with induction therapy based on triple combinations with thalidomide and/or bortezomib, followed with high-doses of Melphalan (HDT, 200mg/m2), and supported with ASCT.
Results
The overall treatment response (CR/VGPR/PR, IMWG criteria), analyzed on +100. day after HDT+ASCT, was achieved in 108 patients (96.4%). According to the R-ISS score, overall treatment response was achieved in all of 58 patients with R-ISS I; in 38/39 (97.4%) with R-ISS II; and in 32/35 (91.4%) with R-ISS III. The median follow up of analyzed group was 52 months (range 12-143 months). The R-ISS was highly statistically relevant regarding both EFS (Log Rank=13.729, p=0.001) and OS (Log Rank=10.486, p= 0.001). Cox regression analysis confirmed that R-ISS was the most important prognostic parameter that influenced OS. (95% CI, 1.056-7.120; p=0.038).
Conclusion
The R-ISS score is highly significant prognostic factor in transplant eligible myeloma patients. It represents currently most sensitive prognostic tool in multiple myeloma with consequent implications to personalized treatment approach.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, prognosis, Treatment