Second revision of the international staging system (R2-ISS) for overall survival in multiple myeloma: a European Myeloma Network (EMN) report within the HARMONY Project
PURPOSE - - Patients with newly diagnosed multiple myeloma (NDMM) show heterogeneous outcomes, and approximately 60% of them are at intermediate-risk according to the Revised International Staging system (R-ISS), the standard-of-care risk stratification model. Moreover, chromosome 1q gain/amplifica...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
[October 10, 2022]
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| In: |
Journal of clinical oncology
Year: 2022, Volume: 40, Issue: 29, Pages: 3406-3418 |
| ISSN: | 1527-7755 |
| DOI: | 10.1200/JCO.21.02614 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1200/JCO.21.02614 Verlag, lizenzpflichtig, Volltext: https://ascopubs.org/doi/10.1200/JCO.21.02614 
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| Author Notes: | Mattia D'Agostino, David A. Cairns, Juan José Lahuerta, Ruth Wester, Uta Bertsch, Anders Waage, Elena Zamagni, María-Victoria Mateos, Daniele Dall'Olio, Niels W.C.J. van de Donk, Graham Jackson, Serena Rocchi, Hans Salwender, Joan Bladé Creixenti, Bronno van der Holt, Gastone Castellani, Francesca Bonello, Andrea Capra, Elias K. Mai, Jan Dürig, Francesca Gay, Sonja Zweegman, Michele Cavo, Martin F. Kaiser, Hartmut Goldschmidt, Jesús María Hernández Rivas, Alessandra Larocca, Gordon Cook, Jesús F. San-Miguel, Mario Boccadoro, and Pieter Sonneveld |
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| 245 | 1 | 0 | |a Second revision of the international staging system (R2-ISS) for overall survival in multiple myeloma |b a European Myeloma Network (EMN) report within the HARMONY Project |c Mattia D'Agostino, David A. Cairns, Juan José Lahuerta, Ruth Wester, Uta Bertsch, Anders Waage, Elena Zamagni, María-Victoria Mateos, Daniele Dall'Olio, Niels W.C.J. van de Donk, Graham Jackson, Serena Rocchi, Hans Salwender, Joan Bladé Creixenti, Bronno van der Holt, Gastone Castellani, Francesca Bonello, Andrea Capra, Elias K. Mai, Jan Dürig, Francesca Gay, Sonja Zweegman, Michele Cavo, Martin F. Kaiser, Hartmut Goldschmidt, Jesús María Hernández Rivas, Alessandra Larocca, Gordon Cook, Jesús F. San-Miguel, Mario Boccadoro, and Pieter Sonneveld |
| 264 | 1 | |c [October 10, 2022] | |
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| 500 | |a Published online May 23, 2022 | ||
| 500 | |a Gesehen am 21.02.2023 | ||
| 520 | |a PURPOSE - - Patients with newly diagnosed multiple myeloma (NDMM) show heterogeneous outcomes, and approximately 60% of them are at intermediate-risk according to the Revised International Staging system (R-ISS), the standard-of-care risk stratification model. Moreover, chromosome 1q gain/amplification (1q+) recently proved to be a poor prognostic factor. In this study, we revised the R-ISS by analyzing the additive value of each single risk feature, including 1q+. - - PATIENTS AND METHODS - - The European Myeloma Network, within the HARMONY project, collected individual data from 10,843 patients with NDMM enrolled in 16 clinical trials. An additive scoring system on the basis of top features predicting progression-free survival (PFS) and overall survival (OS) was developed and validated. - - RESULTS - - In the training set (N = 7,072), at a median follow-up of 75 months, ISS, del(17p), lactate dehydrogenase, t(4;14), and 1q+ had the highest impact on PFS and OS. These variables were all simultaneously present in 2,226 patients. A value was assigned to each risk feature according to their OS impact (ISS-III 1.5, ISS-II 1, del(17p) 1, high lactate dehydrogenase 1, t(4;14) 1, and 1q+ 0.5 points). Patients were stratified into four risk groups according to the total additive score: low (Second Revision of the International Staging System [R2-ISS]-I, 19.2%, 0 points), low-intermediate (II, 30.8%, 0.5-1 points), intermediate-high (III, 41.2%, 1.5-2.5 points), high (IV, 8.8%, 3-5 points). Median OS was not reached versus 109.2 versus 68.5 versus 37.9 months, and median PFS was 68 versus 45.5 versus 30.2 versus 19.9 months, respectively. The score was validated in an independent validation set (N = 3,771, of whom 1,214 were with complete data to calculate R2-ISS) maintaining its prognostic value. - - CONCLUSION - - The R2-ISS is a simple prognostic staging system allowing a better stratification of patients with intermediate-risk NDMM. The additive nature of this score fosters its future implementation with new prognostic variables. | ||
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| 700 | 1 | |a Waage, Anders |e VerfasserIn |4 aut | |
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| 700 | 1 | |a van de Donk, Niels W.C.J. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Jackson, Graham |e VerfasserIn |4 aut | |
| 700 | 1 | |a Rocchi, Serena |e VerfasserIn |4 aut | |
| 700 | 1 | |a Salwender, Hans |e VerfasserIn |4 aut | |
| 700 | 1 | |a Bladé Creixenti, Joan |e VerfasserIn |4 aut | |
| 700 | 1 | |a van der Holt, Bronno |e VerfasserIn |4 aut | |
| 700 | 1 | |a Castellani, Gastone |e VerfasserIn |4 aut | |
| 700 | 1 | |a Bonello, Francesca |e VerfasserIn |4 aut | |
| 700 | 1 | |a Capra, Andrea |e VerfasserIn |4 aut | |
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| 700 | 1 | |a Zweegman, Sonja |e VerfasserIn |4 aut | |
| 700 | 1 | |a Cavo, Michele |e VerfasserIn |4 aut | |
| 700 | 1 | |a Kaiser, Martin F. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Goldschmidt, Hartmut |d 1956- |e VerfasserIn |0 (DE-588)102258023X |0 (DE-627)717003809 |0 (DE-576)365637386 |4 aut | |
| 700 | 1 | |a Hernández Rivas, Jesús María |e VerfasserIn |4 aut | |
| 700 | 1 | |a Larocca, Alessandra |e VerfasserIn |4 aut | |
| 700 | 1 | |a Cook, Gordon |e VerfasserIn |4 aut | |
| 700 | 1 | |a San-Miguel, Jesús F. |e VerfasserIn |4 aut | |
| 700 | 1 | |a Boccadoro, Mario |e VerfasserIn |4 aut | |
| 700 | 1 | |a Sonneveld, Pieter |e VerfasserIn |4 aut | |
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