Clinical utility of the Revised International Staging System in unselected patients with newly diagnosed and relapsed multiple myeloma.
Clinical utility of the Revised International Staging System in unselected patients with newly diagnosed and relapsed multiple myeloma.
复制标题
DOI：
10.1038/bcj.2017.13
复制
发表时间：
2017-02-17
影响因子：
12.8
通讯作者：
Kumar SK
中科院分区：
文献类型：
--
作者：
Tandon N;Rajkumar SV;LaPlant B;Pettinger A;Lacy MQ;Dispenzieri A;Buadi FK;Gertz MA;Hayman SR;Leung N;Go RS;Dingli D;Kapoor P;Lin Y;Hwa YL;Fonder AL;Hobbs MA;Zeldenrust SR;Lust JA;Gonsalves WI;Russell SJ;Kumar SK
我们分析了修订国际分期系统 (RISS) 在未经选择的新诊断多发性骨髓瘤 (NDMM；队列 1) 和复发/难治性多发性骨髓瘤 (RRMM；队列 2) 患者队列中的效用。第 1 组包括 2005 年至 2015 年诊断后 90 天内就诊的 1900 名患者，第 2 组有 887 名患者参加了 Mayo Clinic 的 23 项临床试验。总生存期（OS）和无进展生存期（PFS）是从诊断或试验注册后开始计算的。第 1 组和第 2 组的中位估计随访时间分别为 5 年和 2.3 年。在队列 1 的 1067 名可评估患者中，RISS I 期的中位 OS 和 PFS 分别为 10 和 2.8 年，RISS II 期为 6 和 2.7 年，RISS III 期为 2.6 和 1.3 年（P<0.0001）。在队列 2 的 456 名可评估患者中，RISS I 期的中位 OS 和 PFS 分别为 4.3 和 1.1 年，RISS II 期为 2 和 0.5 年，RISS III 期为 0.8 和 0.2 年（P<0.0001）。总之，RISS 可以更好地将 NDMM 和 RRMM 患者分为三个生存亚组，并且应该用于在未来的临床试验中对患者进行分层。
We analyzed the utility of Revised International staging system (RISS) in an unselected cohort of newly diagnosed multiple myeloma (NDMM; cohort 1), and relapsed/refractory multiple myeloma (RRMM; cohort 2) patients. Cohort 1 included 1900 patients seen within 90 days of diagnosis, from 2005 to 2015, while cohort 2 had 887 patients enrolled in 23 clinical trials at Mayo Clinic. The overall survival (OS) and progression-free survival (PFS) was calculated from the time since diagnosis or trial registration. The median estimated follow up was 5 and 2.3 years for Cohorts 1 and 2, respectively. Among 1067 patients evaluable in Cohort 1, the median OS and PFS was 10 and 2.8 years for RISS stage I, 6 and 2.7 years for RISS stage II and 2.6 and 1.3 years for RISS stage III (P<0.0001). Among 456 patients evaluable in Cohort 2, the median OS and PFS was 4.3 and 1.1 years for RISS stage I, 2 and 0.5 years for RISS stage II and 0.8 and 0.2 years for RISS stage III (P<0.0001). In conclusions, RISS gives a better differentiation of NDMM as well as RRMM patients into three survival subgroups and should be used to stratify patients in future clinical trials.