[Application of the Second Revision of the International Staging System (R2-ISS) in the prognostic assessment of newly diagnosed multiple myeloma].
Zhonghua Xue Ye Xue Za Zhi
; 45(2): 170-177, 2024 Feb 14.
Article
en Zh
| MEDLINE
| ID: mdl-38604794
ABSTRACT
Objective:
To investigate the prognostic value of the Second Revision of the International Staging System (R2-ISS) in patients with newly diagnosed multiple myeloma (NDMM) .Methods:
The retrospective study was performed in 326 NDMM patients with immunomodulatory drugs and/or proteasome inhibitors as the first-line treatment attending the Department of Hematology, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China, from December 2012 to March 2022. The Kaplan-Meier method was used for the survival analysis, with the Log-rank test comparing the between-group differences and Cox proportional risk regression modeling A multifactorial analysis was performed.Results:
â 326 patients were included in the study, 190 of whom were males. The median age was 63 years, and the median followup time was 37 months. R2-ISS can effectively predict prognosis, particularly for R-ISS â ¡ patients. The median progression-free survival (PFS) time of R2-ISS â , R2-ISS â ¡, R2-ISS â ¢, and R2-ISS â £ was 52, 29, 20, and 15 months (P<0.001), while the median overall survival (OS) time was 91, 60, 44, and 36 months (P<0.001). Multifactor analysis revealed that ISS â ¡, ISS â ¢, del (17p), t (4;14), 1q+, LDH increased, and age >65 years old were independent negative prognostic factors for OS. ISS â ¡, ISS â ¢, del (17p), t (4;14), 1q+, and LDH were independent negative prognostic factors for PFS. â¡The C-index score of R2-ISS was 0.724, higher than that of R-ISS (0.678), indicating high prediction efficiency. â¢The median PFS for 1q+-related double-hit in R2-ISS â ¢ and â £ were 20, 15 months (P=0.084) and the median OS were 35, 36 months (P=0.786), respectively. In R2-ISS â ¢, there were twenty-seven cases of 1q+-related double-hit, sixty-one cases of 1q+ single abnormality, and sixty-eight cases with no 1q+. The median PFS for the three groups were 20, 18, and 21 months (P=0.974), while the median OS was 35, 47, and 56 months (P=0.042), respectively. Adjusting the assignment of 1q+ to 1, the median PFS and OS of different R2-ISS stages differed significantly after regrouping (P<0.001) .Conclusions:
The prognostic stratification value of R2-ISS is higher than R-ISS, particularly in the highly heterogeneous R-ISS â ¡ population. Adjusting the assignment of the 1q+-related double-hit can improve R2-ISS, which should be validated in future studies with multi-center and expanded cases.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Mieloma Múltiple
Límite:
Aged
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Female
/
Humans
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Male
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Middle aged
Idioma:
Zh
Revista:
Zhonghua Xue Ye Xue Za Zhi
Año:
2024
Tipo del documento:
Article
País de afiliación:
China