Lu J, Du J, Fu W J, He H Y, Li L, Li R, Zhou L L, Jiang H, Hou J
Department of Hematology, Changzheng Hospital, the Second Military Medical University, The Myeloma and Lymphoma Center, Shanghai 200003, China.
Zhonghua Xue Ye Xue Za Zhi. 2017 Jun 14;38(6):475-479. doi: 10.3760/cma.j.issn.0253-2727.2017.06.003.
To assess the prognostic value of revised international staging system (R-ISS) for multiple myeloma (MM) in real world. A total of 202 newly diagnosis symptomatic MM patients were enrolled from May 2010 to April 2015 and the clinical data were retrospectively analyzed. All the patients received at least four courses of bortezomib-based or thalidomide-based induction therapy. With a median follow-up of 31 months, the cohort included 56 cases in R-ISSⅠ, 108 in R-ISS Ⅱ, and 38 in R-ISS Ⅲ, and the median OS was not reached/61/38 months, respectively (=0.001). According to the ISS system, 62 patients were classified in ISS-Ⅰ, 70 in ISS-Ⅱ and 70 in ISS-Ⅲ, with the median OS was 58, 52 and 40 months, respectively (=0.001). The relative risk () of R-ISS stage Ⅲ Ⅰ, Ⅱ Ⅰ were 9.606 (=0.008) and 4.038 (=0.029). The of Ⅲ Ⅰ, Ⅱ Ⅰ of ISS system were 4.127 (=0.070) and 2.877 (=0.005). In the subgroup analysis, R-ISS predicted survival for patients who were not transplanted (=0.003) , receiving bortezomib-based therapy (=0.010) , and patients younger than 65 years (=0.001). R-ISS system could better predict prognosis for OS in unselected nonclinical trial myeloma patients than ISS system, especially for the younger patients, patients with bortezomib-based therapy, and patients without transplantation.
评估修订后的国际分期系统（R-ISS）在真实世界中对多发性骨髓瘤（MM）的预后价值。2010年5月至2015年4月共纳入202例新诊断的有症状MM患者，并对其临床资料进行回顾性分析。所有患者均接受了至少四个疗程的以硼替佐米或沙利度胺为基础的诱导治疗。中位随访31个月，该队列中R-ISSⅠ期56例，R-ISSⅡ期108例，R-ISSⅢ期38例，中位总生存期分别未达到/61/38个月（=0.001）。根据ISS系统，62例患者被分类为ISS-Ⅰ期，70例为ISS-Ⅱ期，70例为ISS-Ⅲ期，中位总生存期分别为58、52和40个月（=0.001）。R-ISSⅢ期与Ⅰ期、Ⅱ期与Ⅰ期的相对风险（）分别为9.606（=0.008）和4.038（=0.029）。ISS系统Ⅲ期与Ⅰ期、Ⅱ期与Ⅰ期的分别为4.127（=0.070）和2.877（=0.005）。在亚组分析中，R-ISS可预测未接受移植的患者（=0.003）、接受以硼替佐米为基础治疗的患者（=0.010）以及年龄小于65岁的患者（=0.001）的生存期。与ISS系统相比，R-ISS系统能更好地预测未经选择的非临床试验骨髓瘤患者的总生存期，尤其是年轻患者、接受以硼替佐米为基础治疗的患者以及未接受移植的患者。
