Multiple Myeloma International Staging System: "Staging" or Simply "Aging" System?
Multiple Myeloma International Staging System: "Staging" or Simply "Aging" System?
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DOI：
10.1016/j.clml.2013.07.003
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发表时间：
2013-12-01
影响因子：
2.7
通讯作者：
Beauchet, Olivier
中科院分区：
文献类型：
--
作者：
Bataille, Regis;Annweiler, Cedric;Beauchet, Olivier
由于多发性骨髓瘤（MM）生存率差异很大，过去40年来许多研究都集中在MM患者的生物学和细胞遗传学预后价值上。自2005年以来，MM国际分期系统（ISS）已将β-2微球蛋白（β 2 M）与血清白蛋白（SA）浓度的组合视为确定MM患者的最简单和有效的组合。prognosis.in奇怪的是，β 2 M与SA组合的效率的原因仍然不明确。2007年，Fonseca和San Miguel（多发性骨髓瘤的预后因素和分期。Hematol Oncol Clin North Am 2007; 21：1115-40）强调细胞遗传学评估也可用于评估MM预后。此外，基因组方法最近出现了新的前景。在此，我们（1）质疑β 2 M和SA作为MM预后标志物的具体依据，（2）强调β 2 M和SA作为老年人合并症有效生物标志物的良好记录的预后意义，（3）得出结论，目前的MM-ISS是年龄相关合并症负担的分期系统（即老化系统）比特定的MM分期系统，不应单独使用。因此，我们建议：（1）细胞遗传学MM-ISS法可作为标准方法;（2）基因组学发现的一些因素可反映MM克隆的合并症负担和内在恶性程度，因此需要进一步研究;（3）在等待标准基因组分类的同时。
Because of the wide variation in multiple myeloma (MM) survival, numerous studies have focused over the past 40 years on the biological and cytogenetic prognostic values in MM patients. Since 2005, the MM International Staging System (ISS) has recognized the combination of beta-2 microglobulin (beta 2M) with serum albumin (SA) concentrations as the most simple and potent combination to determine the prognosis.in MM patients. Curiously, the reasons for the efficiency of the combination of beta 2M with SA remain not clear-cut. In 2007, Fonseca and San Miguel (Prognostic factors and staging in multiple myeloma. Hematol Oncol Clin North Am 2007; 21:1115-40) underlined that cytogenetic assessment might also be useful for evaluating MM prognosis. Furthermore, new perspectives recently appeared with the genomic approach. Here, we (1) question the specific rationale for beta 2M and SA as prognostic markers in MM, (2) emphasize the well-documented prognostic implications of beta 2M and SA as potent biomarkers of comorbidity in older adults, and (3) conclude that the current MM-ISS is rather a staging system for age-related comorbidity burden (ie, aging system) than a specific MM staging system, and should not be used alone. Thus, we suggest that: (1) cytogenetics with the superscript MM-ISS could be the standard method; (2) some factors discovered using genomics could reflect the comorbidity burden and the intrinsic malignancy of MM clone, and thus needs more investigation; and (3) while waiting for standard genomic classification.