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Revised Staging System Prognostic for Multiple Myeloma

ISS plus chromosomal abnormalities, lactate dehydrogenase prognostic in multiple myeloma

TUESDAY, Aug. 4, 2015 (HealthDay News) — The International Staging System (ISS) combined with chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization after CD138 plasma cell purification and serum lactate dehydrogenase (LDH) has prognostic value in newly-diagnosed multiple myeloma (NDMM), according to a study published online Aug. 3 in the Journal of Clinical Oncology.

Antonio Palumbo, M.D., from the University of Torino in Italy, and colleagues assessed the prognostic value of the combined ISS in NDMM. The authors pooled clinical and laboratory data for 4,445 patients with NDMM enrolled onto 11 international trials. ISS, CA, and LDH data were available for 3,060 of the patients.

The researchers defined three groups: revised ISS (R-ISS) I (871 patients), including ISS stage I, no high-risk CA, and normal LDH levels; R-ISS III (295 patients), including ISS stage III and high-risk CA or high LDH levels; and R-ISS II (1,894 patients), including all other possible combinations. The five-year overall survival was 82, 62, and 40 percent, respectively, in R-ISS I, R-ISS II, and R-ISS III, at a median follow-up of 46 months. The corresponding five-year progression-free survival rates were 55, 36, and 24 percent, respectively.

“The R-ISS is a simple and powerful prognostic staging system, and we recommend its use in future clinical studies to stratify patients with NDMM effectively with respect to the relative risk to their survival,” the authors write.

Several authors disclosed financial ties to the pharmaceutical and biotechnology industries.

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