Clinical utility of the Revised International Staging System in unselected patients with newly diagnosed and relapsed multiple myeloma

• Published in: Blood cancer journal (New York) Vol. 7; no. 2; p. e528
• Main Authors: Tandon, N, Rajkumar, S V, LaPlant, B, Pettinger, A, Lacy, M Q, Dispenzieri, A, Buadi, F K, Gertz, M A, Hayman, S R, Leung, N, Go, R S, Dingli, D, Kapoor, P, Lin, Y, Hwa, Y L, Fonder, A L, Hobbs, M A, Zeldenrust, S R, Lust, J A, Gonsalves, W I, Russell, S J, Kumar, S K
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 17.02.2017; Nature Publishing Group
• Subjects: Adult; Aged; Aged, 80 and over; Cohort Studies; Female; Humans; Male; Middle Aged; Multiple Myeloma - diagnosis; Multiple Myeloma - mortality; Multiple Myeloma - pathology; Neoplasm Staging - methods; Original; Prognosis; Young Adult
• ISSN: 2044-5385; 2044-5385
• DOI: 10.1038/bcj.2017.13

We analyzed the utility of Revised International staging system (RISS) in an unselected cohort of newly diagnosed multiple myeloma (NDMM; cohort 1), and relapsed/refractory multiple myeloma (RRMM; cohort 2) patients. Cohort 1 included 1900 patients seen within 90 days of diagnosis, from 2005 to 2015, while cohort 2 had 887 patients enrolled in 23 clinical trials at Mayo Clinic. The overall survival (OS) and progression-free survival (PFS) was calculated from the time since diagnosis or trial registration. The median estimated follow up was 5 and 2.3 years for Cohorts 1 and 2, respectively. Among 1067 patients evaluable in Cohort 1, the median OS and PFS was 10 and 2.8 years for RISS stage I, 6 and 2.7 years for RISS stage II and 2.6 and 1.3 years for RISS stage III (P<0.0001). Among 456 patients evaluable in Cohort 2, the median OS and PFS was 4.3 and 1.1 years for RISS stage I, 2 and 0.5 years for RISS stage II and 0.8 and 0.2 years for RISS stage III (P<0.0001). In conclusions, RISS gives a better differentiation of NDMM as well as RRMM patients into three survival subgroups and should be used to stratify patients in future clinical trials.