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Cited 31 time in webofscience Cited 34 time in scopus
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Comprehensive evaluation of the revised international staging system in multiple myeloma patients treated with novel agents as a primary therapyopen access

Authors
Cho, HyungwooYoon, Dok HyunLee, Jung BokKim, Sung-YongMoon, Joon HoDo, Young RokLee, Jae HoonPark, YongLee, Ho SupEom, Hyeon SeokShin, Ho-JinMin, Chang-KiKim, Jin SeokJo, Jae-CheolKang, Hye JinMun, Yeung-ChulLee, Won SikLee, Je-JungSuh, CheolwonKim, Kihyun
Issue Date
Dec-2017
Publisher
WILEY
Citation
AMERICAN JOURNAL OF HEMATOLOGY, v.92, no.12, pp 1280 - 1286
Pages
7
Indexed
SCI
SCIE
SCOPUS
Journal Title
AMERICAN JOURNAL OF HEMATOLOGY
Volume
92
Number
12
Start Page
1280
End Page
1286
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/4420
DOI
10.1002/ajh.24891
ISSN
0361-8609
1096-8652
Abstract
The revised International Staging System (R-ISS) has recently been developed to improve the risk stratification of multiple myeloma (MM) patients over the ISS. We assessed the R-ISS in MM patients who were treated with novel agents as a primary therapy and evaluated its discriminative power and ability to reclassify patients from the ISS. A total of 514 newly diagnosed MM patients treated with novel agents including thalidomide, bortezomib, and lenalidomide as a primary therapy were included in this retrospective analysis. With a median follow-up duration of 42.3 months (range, 40.5-44.1), the median overall survival (OS) was 61.0 months. There was a significant difference in median OS (not reached, 60.9, and 50.1 months for stages 1, 2, and 3, respectively, P<0.001) among the three stages of R-ISS. The C-statistic was significantly greater for R-ISS than for ISS (0.769 vs. 0.696, P<0.001). The event NRI was -0.08 (95% confidence interval [CI], -0.18-0.01) and the non-event NRI was 0.05 (95% CI, -0.03-0.10), resulting in a total NRI of -0.03 (95% CI, -0.14-0.08, P=0.602). The R-ISS performs well and has significantly better discriminative power than the ISS in MM patients treated with novel agents as a primary therapy. However, it does not better reclassify patients from the ISS, suggesting that there is still room to improve the staging system. Moreover, new statistical measures for assessing and quantifying the risk prediction of new prognostic models are necessary in future studies.
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Park, Yong
Anam Hospital (Department of Medical Oncology and Hematology, Anam Hospital)
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