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Heterogeneity in Long Term Outcomes for R-ISS Stage II in Newly Diagnosed Multiple Myeloma Patients.

Anais Schavgoulidze 1 Valérie Lauwers-Cances 2, 3 Aurore Perrot 4 Titouan Cazaubiel Marie-Lorraine Chretien 5 Philippe Moreau 6 Thierry Facon 7 Xavier Leleu 8 Lionel Karlin 9 Anne-Marie Stoppa 10 Olivier Decaux 11 Karim Belhadj 12 Bertrand Arnulf 13, 14 Mohamad Mohty 15, 16 Clara M. Ariette Cecile Fohrer-Sonntag Pascal Lenain 17 Jean-Pierre Marolleau 18, 19 Mourad Tiab 20 Carla Araujo 21 Frederique Orsini-Piocelle 22 Arnaud Jaccard 23 Murielle Roussel 23 Lotfi Benboubker 24 Jean-Richard Eveillard 25 Mamoun Dib 26 Marion Divoux 27 Michel Attal 4 Herve Avet-Loiseau 28, 3 Jill Corre 29 
Abstract : In the era of personalized treatment in multiple myeloma, high-risk patients must be accurately defined. The International Myeloma Working Group recommends using the Revised International Staging System (R-ISS) to identify high-risk patients. The main purpose of our work was to explore the heterogeneity of outcome among R-ISS stage II patients assessing the impact of ISS, chromosomal abnormalities (CA) and LDH level in this subgroup. Data were issued from 1,343 newly diagnosed myeloma patients up to 65 years, enrolled in 3 clinical trials implemented by the Intergroupe Francophone du Myelome. All patients were eligible to an intensive treatment. Patients R-ISS stage II but ISS stage I had 1.6 times more risk of death than patients R-ISS stage I (adjusted HR 1.6; 95% CI, 1.1 to 2.2; P = .01) and patients R-ISS stage II but ISS stage III had a better overall survival than patients R-ISS stage III (adjusted HR 0.7; 95% CI, 0.4 to 0.9, P = .02). However, among patients classified in R-ISS II, ISS stage and CA (del(17p) and t(4;14)) were still relevant prognostic factors for death. Dividing R-ISS stage II into 3 subgroups: ISS I with standard risk CA, ISS II or III with standard risk CA and, high risk CA patients, median overall survivals were respectively not reached, 112 and 71 months (P < 0.001). In conclusion, stratification of patients in the R-ISS stage II group can be improved by taking into account CA and ISS. However, this does not improve predictive performance of survival models.
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Soumis le : jeudi 6 octobre 2022 - 18:20:22
Dernière modification le : mercredi 23 novembre 2022 - 12:02:28

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Anais Schavgoulidze, Valérie Lauwers-Cances, Aurore Perrot, Titouan Cazaubiel, Marie-Lorraine Chretien, et al.. Heterogeneity in Long Term Outcomes for R-ISS Stage II in Newly Diagnosed Multiple Myeloma Patients.. Haematologica, 2022, ⟨10.3324/haematol.2021.280566⟩. ⟨hal-03801805⟩



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