Relevant prognostic features of multiple myeloma and the new International Staging System

Key Points Combination of ISS and the EMC92 gene classifier is a novel clinically applicable risk classification for survival in multiple myeloma. ISS has clear independent additive prognostic value in combination with GEP classifiers or FISH markers.

Download Full-text

Impact of Serum Albumin and B2-Microglobulin level on 2-Year Overall Survival among Newly Diagnosed Multiple Myeloma Patients: A retrospective Study

RAS Medical Science ◽

10.51520/2766-5240-5 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Sherian Salama ◽

Rodaina Yousef ◽

Asma Al Olama ◽

Mahmoud Marashi ◽

Hana Salama ◽

...

Keyword(s):

Multiple Myeloma ◽

Serum Albumin ◽

United Arab Emirates ◽

Staging System ◽

Albumin Level ◽

Age At Diagnosis ◽

Newly Diagnosed ◽

International Staging System ◽

Beta 2 ◽

Beta 2 Microglobulin

Background: Multiple myeloma accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. Evaluation and initial staging of the disease is made once the diagnosis is confirmed. The recommended staging system is the International Staging System (ISS). Which determines the Myeloma prognosis by 2 factors: beta-2 Microglobulin and Serum albumin. Goal and Objective: The main goal of this study is to assess the effect of Beta-2 microglobulin and Serum albumin on patient’s survival rate with Multiple Myeloma. The secondary objective is to compare the age at diagnosis with other literature. Methodology: The current study was carried out in Hematology Unit, Dubai Hospital, Dubai, Dubai Health Authority (DHA), United Arab Emirates. Chart review was done retrospectively for 49 newly diagnosed patients with Multiple Myeloma diagnosed between the period 2012-2016. Purposive sample was used to those patients who met the inclusion criteria of this study, to be diagnosed and treated in DH. diagnosed and received regular treatment in Dubai Hospital. Results: Medina follow-up of the patients in this study was (12.8) months. The 2-year overall survival rate for patients with Multiple Myeloma (n = 49) was approximately 80%. While, the 2-year OS rate based on Albumin level. Patients with albumin level > 3.5 mg\dl was significantly higher compared to those who had an albumin level <3.5 mg\dl. 100%, 65% respectively, P = 0.033. Moreover, the 2-year OS rate in terms B2MG level. Patients who had a B2MG < 3.5 mg\dl OS was slightly higher compared to those who had (3.5-5.5 and 5.5 mg\dl). OS rate approximately 85 %, 80 % and 75 respectively, P = .737 Conclusion: Multiple myeloma (MM) is a very heterogeneous disease. For this reason, various prognostic factors and staging systems have been developed to predict the disease outcome. International Staging System (ISS) is very useful in determine the survival based on serum β2- microglobulin and serum albumin levels. The age at diagnosis in Dubai hospital, United Arab Emirates is much younger compared to other studies conducted worldwide. The sample used in the study was also highly diverse in terms of culture and nationality. Such diversity is largely typical in Gulf especially in United Arab Emirates. Therefore, this can play important role in age at diagnosis.

Download Full-text

High Expression Levels of Long Noncoding RNA Small Nucleolar RNA Host Gene 18 and Semaphorin 5A Indicate Poor Prognosis in Multiple Myeloma

Acta Haematologica ◽

10.1159/000502404 ◽

2019 ◽

Vol 143 (3) ◽

pp. 279-288 ◽

Cited By ~ 1

Author(s):

Ling-Juan Huang ◽

Ying Shen ◽

Ju Bai ◽

Fang-Xia Wang ◽

Yuan-Dong Feng ◽

...

Keyword(s):

Multiple Myeloma ◽

Noncoding Rna ◽

Poor Prognosis ◽

Clinical Characteristics ◽

Staging System ◽

High Expression ◽

Newly Diagnosed ◽

High Expression Group ◽

International Staging System ◽

Nucleolar Rna

Background: The aim of this study was to detect the expression of long noncoding RNA small nucleolar RNA host gene 18 (SNHG18) andsemaphorin 5A (SEMA5A) genes in multiple myeloma (MM) patients and to explore the correlation of the expression of these genes with the clinical characteristics and prognosis of MM patients. Methods: Forty-seven newly diagnosed MM, 18 complete remission MM, 13 refractory/relapse MM, and 22 iron deficiency anemia (serving as control) samples were extracted at the Department of Hematology, Second Aﬃliated Hospital of Xian Jiaotong University between January 2015 and December 2016. The clinical features of the MM patients are summarized. Real-time quantitative PCR was performed to analyze the relative expression levels of the SNHG18 and SEMA5Agenes. The clinical characteristics and overall survival (OS) of the MM patients were statistically analyzed while measuring different levels of SNHG18 and SEMA5Agene expression. At the same time, the correlation between the expression of SNHG18 and SEMA5A was also analyzed. Results: The analysis confirmed that SNHG18 and its possible target gene SEMA5A were both highly expressed in newly diagnosed MM patients. After analyzing the clinical signiﬁcance of SNHG18 and SEMA5A in MM patients, we found that the expression of SNHG18 and SEMA5A was related to the Durie-Salmon (DS), International Staging System (ISS), and Revised International Staging System (R-ISS) classification systems, and the Mayo Clinic Risk Stratification for Multiple Myeloma (mSMART; p < 0.05). Moreover, we observed a significant difference in OS between the SNHG18/SEMA5A high expression group and the low expression group. We found a positive correlation between SNHG18 and SEMA5A expression (r = 0.709, p < 0.01). Surprisingly, the expected median OS times of both the SNHG18 and SEMA5Ahigh expression groups were significantly decreased, which was in contrast to those of both the SNHG18 and SEMA5Alow expression groups and the single-gene high expression group (p < 0.05). Conclusion: High expression of both SNHG18 and SEMA5A is associated with poor prognosis in patients with MM.

Download Full-text

Next Generation Sequencing-based Validation of the Revised International Staging System for Multiple Myeloma: An Analysis of the MMRF CoMMpass Study

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/j.clml.2019.01.003 ◽

2019 ◽

Vol 19 (5) ◽

pp. 285-289 ◽

Cited By ~ 3

Author(s):

Scott R. Goldsmith ◽

Mark A. Fiala ◽

James Dukeman ◽

Armin Ghobadi ◽

Keith Stockerl-Goldstein ◽

...

Keyword(s):

Multiple Myeloma ◽

Next Generation Sequencing ◽

Staging System ◽

Next Generation ◽

International Staging System ◽

Generation Sequencing

Download Full-text

Early mortality in elderly patients undergoing treatment for multiple myeloma in real-world practice

Journal of International Medical Research ◽

10.1177/0300060518757640 ◽

2018 ◽

Vol 46 (6) ◽

pp. 2230-2237

Author(s):

Jun Xia ◽

Lingling Wang ◽

Xin Zhou ◽

Jing Wang ◽

Huan Wang ◽

...

Keyword(s):

Multiple Myeloma ◽

Lactate Dehydrogenase ◽

Elderly Patients ◽

Real World ◽

Staging System ◽

Early Mortality ◽

Stage Iii ◽

Newly Diagnosed ◽

International Staging System ◽

High Lactate

Objectives This study was performed to analyze the risk factors for early mortality (EM) in elderly patients undergoing treatment for multiple myeloma (MM) in real-world clinical practice. Methods Retrospective data from 108 elderly patients who were newly diagnosed with MM from January 2007 to July 2015 were analyzed in a single hematology center. EM was defined as death of any cause within 12 months after diagnosis. A multivariate regression model was used to evaluate EM. Results EM occurred in 16 (14.8%) elderly patients with newly diagnosed MM. The most common cause of death was infection (10/16, 62.5%). In the multivariate analysis, only an age of ≥75 years, International Staging System (ISS) stage III disease, and high lactate dehydrogenase concentration were significantly and independently associated with EM. Conclusion Our results suggest that infection is the leading cause of EM in elderly patients with MM. An age of ≥75 years, ISS stage III disease, and a high lactate dehydrogenase concentration are significant predictors of EM. We should further target this higher-risk patient population to define personalized therapy with which to improve outcomes.

Download Full-text

Incorporation of the bone marker carboxy-terminal telopeptide of type-1 collagen improves prognostic information of the International Staging System in newly diagnosed symptomatic multiple myeloma

Leukemia ◽

10.1038/leu.2008.159 ◽

2008 ◽

Vol 22 (9) ◽

pp. 1767-1772 ◽

Cited By ~ 33

Author(s):

C Jakob ◽

J Sterz ◽

P Liebisch ◽

M Mieth ◽

J Rademacher ◽

...

Keyword(s):

Multiple Myeloma ◽

Staging System ◽

Bone Marker ◽

Newly Diagnosed ◽

Prognostic Information ◽

International Staging System ◽

Carboxy Terminal

Download Full-text

Exchange of International Staging System for Durie&Salmon Staging System in Therapeutic Strategy for Multiple Myeloma.

Blood ◽

10.1182/blood.v106.11.5167.5167 ◽

2005 ◽

Vol 106 (11) ◽

pp. 5167-5167

Author(s):

Shingo Kurahashi ◽

Hiroto Narimatsu ◽

Takumi Sugimoto ◽

Isamu Sugiura

Keyword(s):

Multiple Myeloma ◽

Overall Survival ◽

Clinical Outcome ◽

Therapeutic Strategy ◽

Staging System ◽

Stage I ◽

Stage Ii ◽

Clinical Staging ◽

Secondary Malignancy ◽

International Staging System

Abstract Introduction: Since multiple myeloma (MM) is not a curative disease and clinical outcome is variable, chemotherapy is started only when patients developed organ impairment or progression of disease. As for clinical staging, Durie&Salmon (DS) system is in use. The International Staging System (ISS) for MM has been recently reported to provide simple and useful prognostic grouping (Greipp et al. 2005). However, its usefulness in therapeutic strategy has not been clearly demonstrated. Patients and methods: We reviewed medical records of patients with MM, newly diagnosed in Toyohashi Municipal Hospital between May 1997 and April 2004. They were all stratified based on both ISS and DS system. Results: The median age of 55 patients was 67 years (range; 46–86). M protein isotypes included IgG (n=33), IgA (n=13), BJP (n=6) and IgD (n=1). Fifty-two patients were treated with chemotherapy and 12 of those patients underwent autologous peripheral blood stem cell transplantation. The median follow-up of the patients was 26.8 months (range; 1.4–77.5). Their staging and overall survival (OS) are summarized on the following table. ISS predicted OS more clearly than DS system in our study. Overall survival based on ISS and DS system ISS DS stage no. of patients OS at 3 yrs no. of patients OS at 3 yrs I 14 1.00 3 0.67 II 22 0.55 20 0.79 III 19 0.25 32 0.40 p-value 0.0102 0.3287 Thirteen of the 14 patients with ISS stage I are alive at median months of 31.5 (10.4–73.8), and only one patient died of secondary malignancy at 44.9 months from diagnosis. The patients with ISS stage I included 86% of DS stage II and III patients, who are usually required treatment. Conclusions and discussions: ISS could predict clinical outcome more clearly than DS system. The patients’ prognosis was good in ISS stage I although many patients with DS stage II and III was included in this group. We suggests that early treatment to the patients with ISS stage I might not be necessarily required. Further studies are needed to adopt ISS instead of DS system in therapeutic strategy. Figure Figure

Download Full-text