Development and validation of a novel risk stratification algorithm for relapsed multiple myeloma.
algorithm
multiple myeloma
overall survival
relapsed
risk stratification
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
22
01
2019
accepted:
11
05
2019
pubmed:
8
8
2019
medline:
9
7
2020
entrez:
8
8
2019
Statut:
ppublish
Résumé
Multiple myeloma (MM) is a malignancy with varying survival outcomes and drivers of disease progression. Existing MM staging tools were developed using data from newly diagnosed patients. As patient characteristics and disease-related factors change between diagnosis and the initiation of second-line (2L) treatment, an unmet need exists for a tool that can evaluate risk of death at first relapse. We have developed a risk stratification algorithm (RSA) using data from patients with MM who were at 2L. Hazard ratios for independent predictors of overall survival (OS) were derived from a Cox models, and individual patient scores were calculated for total risk. K-adaptive partitioning for survival was used to stratify patients into groups based on their scores. Relative risk doubled with ascending risk group; median OSs for patients in group 1 (lowest risk)-4 (highest risk) were 61·6, 29·6, 14·2 and 5·9 months, respectively. Differences in OS between risk groups were significant. Similar stratification was observed when the RSA was applied to an external validation data set. In conclusion, we have developed a validated RSA that can quantify total risk, frailty risk and disease aggressiveness risk, and stratify patients with MM at 2L into groups with profoundly different survival expectations.
Identifiants
pubmed: 31388996
doi: 10.1111/bjh.16105
pmc: PMC6899684
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
447-458Informations de copyright
© 2019 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.
Références
J Clin Oncol. 2005 May 20;23(15):3412-20
pubmed: 15809451
CA Cancer J Clin. 2017 Sep;67(5):362-377
pubmed: 28731537
Eur J Haematol. 2010 Aug;85(2):114-9
pubmed: 20477863
Leukemia. 2017 Sep;31(9):1915-1921
pubmed: 28008176
Haematologica. 2016 Aug;101(8):995
pubmed: 27478200
BMC Med Res Methodol. 2011 Sep 19;11:129
pubmed: 21929796
Leukemia. 2014 Feb;28(2):269-77
pubmed: 23974982
Blood. 2015 Mar 26;125(13):2068-74
pubmed: 25628469
N Engl J Med. 2016 Aug 25;375(8):754-66
pubmed: 27557302
Br J Haematol. 2011 Jul;154(1):32-75
pubmed: 21569004
Br J Haematol. 2016 Oct;175(1):66-76
pubmed: 27291397
Lancet Oncol. 2011 Jul;12(7):617-9
pubmed: 21664869
Blood Cancer J. 2015 Oct 23;5:e363
pubmed: 26495860
J Clin Epidemiol. 2004 Nov;57(11):1138-46
pubmed: 15567629
N Engl J Med. 2016 Apr 28;374(17):1621-34
pubmed: 27119237
Lancet Oncol. 2016 Jan;17(1):27-38
pubmed: 26671818
Ann Oncol. 2017 Jul 1;28(suppl_4):iv52-iv61
pubmed: 28453614
Haematologica. 2012 Aug;97(8):1272-7
pubmed: 22371180
Blood Cancer J. 2017 Feb 17;7(2):e528
pubmed: 28211889
Int J Epidemiol. 2010 Apr;39(2):417-20
pubmed: 19926667
Eur J Cancer. 2010 Jan;46(1):160-9
pubmed: 19682891
Br J Haematol. 2016 Oct;175(2):252-264
pubmed: 27411022
N Engl J Med. 2015 Jan 8;372(2):142-52
pubmed: 25482145
CMAJ. 2012 Aug 7;184(11):1265-9
pubmed: 22371511
Leukemia. 2009 Dec;23(12):2210-21
pubmed: 19798094
N Engl J Med. 2016 Oct 6;375(14):1319-1331
pubmed: 27705267
MDM Policy Pract. 2019 Jan 17;4(1):2381468318814253
pubmed: 30729167
J Clin Oncol. 2015 Sep 10;33(26):2863-9
pubmed: 26240224
Cancer Treat Rev. 2015 Dec;41(10):827-35
pubmed: 26296679