International staging system for multiple myeloma
International staging system for multiple myeloma
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DOI：
10.1200/jco.2005.04.242
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发表时间：
2005-05-20
影响因子：
45.3
通讯作者：
Westin, J
中科院分区：
文献类型：
--
作者：
Greipp, PR;San Miguel, J;Westin, J
目的：有必要为多发性骨髓瘤，可以应用于国际上的患者分类和stabilizing.Patients和方法的一个简单，可靠的分期系统收集了临床和实验室数据的10，750例以前未经治疗的症状性骨髓瘤患者从17个机构，包括网站在北美，欧洲和亚洲。通过单变量和多变量技术评估潜在的预后因素。三种建模方法，然后探讨开发一个分期系统，包括两个非树和树生存assessmentmethods.Results血清β（2）-微球蛋白（S β M-2），血清白蛋白，血小板计数，血清肌酐，年龄成为强大的预测生存，然后在树分析方法。S β M-2和血清白蛋白的组合提供了最简单、最强大和可重复的三阶段分类。这个新的国际分期系统（ISS）在其余患者中得到了验证，包括以下阶段：I期，S β M-2小于3.5 mg/L，血清白蛋白>= 3.5 g/dL（中位生存期，62个月）; II期，非I期或III期（中位生存期，44个月）;和III期，S β M-2 >= 5.5 mg/L（中位生存期，29个月）。ISS系统在北美、欧洲和亚洲患者中的有效性得到了进一步验证;在小于和≥ 65岁的患者中;在标准治疗或自体移植的患者中;结论新的ISS方法简单，基于易于使用的变量，并与Durie/Salmon分期系统进行比较（S β M-2和血清白蛋白），并建议早期采用和广泛使用。(c)2005年，美国临床肿瘤学会。
Purpose There is a need for a simple, reliable staging system for multiple myeloma that can be applied internationally for patient classification and stratification.Patients and Methods Clinical and laboratory data were gathered on 10,750 previously untreated symptomatic myeloma patients from 17 institutions, including sites in North America, Europe, and Asia. Potential prognostic factors were evaluated by univariate and multivariate techniques. Three modeling approaches were then explored to develop a staging system including two nontree and one tree survival assessment methodologies.Results Serum beta(2)-microglobulin (S beta M-2), serum albumin, platelet count, serum creatinine, and age emerged as powerful predictors of survival and were then used in the tree analysis approach. A combination of S beta M-2 and serum albumin provided the simplest, most powerful and reproducible three-stage classification. This new International Staging System (ISS) was validated in the remaining patients and consists of the following stages: stage I, S beta M-2 less than 3.5 mg/L plus serum albumin >= 3.5 g/dL (median survival, 62 months); stage II, neither stage I nor III (median survival, 44 months); and stage III, S beta M-2 >= 5.5 mg/L (median survival, 29 months). The ISS system was further validated by demonstrating effectiveness in patients in North America, Europe, and Asia; in patients less than and >= 65 years of age; in patients with standard therapy or autotransplantation; and in comparison with the Durie/Salmon staging system.Conclusion The new ISS is simple, based on easy to use variables (S beta M-2 and serum albumin), and recommended for early adoption and widespread use. (c) 2005 by American Society of Clinical Oncology.