Revised International Staging System Is Predictive and Prognostic for Early Relapse (<24 months) after Autologous Transplantation for Newly Diagnosed Multiple Myeloma.

Autor: Gopalakrishnan S; Health Science North, Sudbury, Ontario, Canada., D'Souza A; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin., Scott E; Center for Hematologic Malignancies, The Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon., Fraser R; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, Wisconsin., Davila O; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin., Shah N; Department of Stem Cell Transplantation, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas., Gale RP; Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom., Kamble R; Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas., Diaz MA; Department of Hematology/Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain., Lazarus HM; Seidman Cancer Center, Division of Hematology Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio., Savani BN; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Hildebrandt GC; Markey Cancer Center, University of Kentucky, Lexington, Kentucky., Solh M; The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia., Freytes CO; Texas Transplant Institute, San Antonio, Texas., Lee C; Royal Adelaide Hospital, Adelaide, SA, Australia., Kyle RA; Mayo Clinic Rochester, Rochester, Minnesota., Usmani SZ; Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, North Carolina., Ganguly S; Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, Kansas., Assal A; Columbia University Medical Center, New York, New York., Berdeja J; Sarah Cannon BMT Program, Nashville, Tennessee., Kanate AS; Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, West Virginia., Dhakal B; Medical College of Wisconsin, Division of Hematology Oncology; Milwaukee, Wisconsin., Meehan K; Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire., Kindwall-Keller T; Division of Hematology/Oncology, University of Virginia Health System, Charlottesville, Virginia., Saad A; Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama., Locke F; Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida., Seo S; Department of Hematology & Oncology, National Cancer Research Center East, Chiba, Japan., Nishihori T; Department of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida., Gergis U; Hematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York., Gasparetto C; Duke University Medical Center, Durham, North Carolina., Mark T; University of Colorado Hospital, Division of Hematology Oncology; Aurora, Colorado., Nieto Y; Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas., Kumar S; Mayo Clinic Rochester, Rochester, Minnesota., Hari P; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: phari@mcw.edu.
Jazyk: angličtina
Zdroj: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [Biol Blood Marrow Transplant] 2019 Apr; Vol. 25 (4), pp. 683-688. Date of Electronic Publication: 2018 Dec 21.
DOI: 10.1016/j.bbmt.2018.12.141
Abstrakt: The revised International Staging System (R-ISS) combines ISS with genetic markers and lactate dehydrogenase and can prognosticate newly diagnosed multiple myeloma (MM). Early relapse (<24 months) after upfront autologous hematopoietic cell transplantation (AHCT) strongly predicts inferior overall survival (OS). We examined the ability of R-ISS in predicting early relapse and its independent prognostic effect on postrelapse survival after an early relapse. Using the Center for International Blood and Marrow Transplant Research database we identified MM patients receiving first AHCT within 18 months after diagnosis with available R-ISS stage at diagnosis (n = 628). Relative risks of relapse/progression, progression-free survival (PFS), and OS were calculated with the R-ISS group as a predictor in multivariate analysis. Among early relapsers, postrelapse survival was tested to identify factors affecting postrelapse OS. The cumulative incidence of early relapse was 23%, 39%, and 50% for R-ISS I, R-ISS II, and R-ISS III, respectively (P < .001). Shorter PFS and OS were seen with higher stage R-ISS. R-ISS was independently predictive for inferior postrelapse OS among early relapsers, as was the presence of ≥3 comorbidities and the use of ≥2 induction chemotherapy lines. R-ISS stage at diagnosis predicts early post-AHCT relapse and independently affects postrelapse survival among early relapsers.
(Copyright © 2018 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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