Tandon N, Rajkumar S V, LaPlant B, Pettinger A, Lacy M Q, Dispenzieri A, Buadi F K, Gertz M A, Hayman S R, Leung N, Go R S, Dingli D, Kapoor P, Lin Y, Hwa Y L, Fonder A L, Hobbs M A, Zeldenrust S R, Lust J A, Gonsalves W I, Russell S J, Kumar S K
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Blood Cancer J. 2017 Feb 17;7(2):e528. doi: 10.1038/bcj.2017.13.
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.
我们分析了修订后的国际分期系统（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。队列1包括2005年至2015年诊断后90天内就诊的1900例患者，而队列2有887例患者参加了梅奥诊所的23项临床试验。总生存期（OS）和无进展生存期（PFS）从诊断或试验登记时间开始计算。队列1和队列2的中位估计随访时间分别为5年和2.3年。在队列1中可评估的1067例患者中，RISS I期的中位OS和PFS分别为10年和2.8年，RISS II期为6年和2.7年，RISS III期为2.6年和1.3年（P<0.0001）。在队列2中可评估的456例患者中，RISS I期的中位OS和PFS分别为4.3年和1.1年，RISS II期为2年和0.5年，RISS III期为0.8年和0.2年（P<0.0001）。总之，RISS能更好地将NDMM和RRMM患者分为三个生存亚组，应在未来的临床试验中用于对患者进行分层。
