Chen Haimin, Shi Haotian, Zhou Nian, Yu Wenjun, Wu Lixia, Peng Rong, Wei Wei, Wang Dongjiao, Zhou Fan
Department of Hematology and Oncology, Shanghai Jing'an District Zhabei Central Hospital, Shanghai, China.
Eur J Haematol. 2023 Mar;110(3):229-235. doi: 10.1111/ejh.13897. Epub 2022 Nov 23.
Recently, the Mayo Clinic introduced a new staging system (the Mayo Additive Staging System [MASS]) for patients with newly diagnosed multiple myeloma (NDMM) based on the number of high-risk (HR) abnormalities, including HR IgH translocations, 1q gain/amplification, chromosome 17 abnormalities, International Staging System (ISS)-III, and elevated lactate dehydrogenase. Patients with 0, 1, or ≥2 HR abnormalities were defined as stage I, II, or III, respectively. We aimed to validate the real-world prognostic value of the MASS.
We retrospectively analyzed the cytogenetic and laboratory results of 544 patients with NDMM at a single center.
Ninety (16.5%) patients had no HR factors (MASS I), 193 (35.5%) had 1 HR factor (MASS II), and 261 (48%) had ≥2 HR factors (MASS III). The median progression-free survival (PFS) and overall survival (OS) times were 48, 28, and 20 months and 137, 73, and 39 months in the three groups, respectively (p < .001). In the subgroup analysis, patients had different OS outcomes based on the MASS when grouped by age, renal function, or therapeutic regimens. The MASS identified patients with the worst outcomes among those rated revised ISS II.
The MASS system is a reliable risk stratification tool for patients with NDMM in real-world clinical practice.
最近，梅奥诊所基于高危（HR）异常的数量，为新诊断的多发性骨髓瘤（NDMM）患者引入了一种新的分期系统（梅奥附加分期系统 [MASS]），这些高危异常包括HR IgH易位、1q获得/扩增、17号染色体异常、国际分期系统（ISS）III期以及乳酸脱氢酶升高。有0、1或≥2个HR异常的患者分别被定义为I期、II期或III期。我们旨在验证MASS在现实世界中的预后价值。
我们回顾性分析了单中心544例NDMM患者的细胞遗传学和实验室检查结果。
90例（16.5%）患者无HR因素（MASS I期），193例（35.5%）有1个HR因素（MASS II期），261例（48%）有≥2个HR因素（MASS III期）。三组患者的中位无进展生存期（PFS）和总生存期（OS）分别为48、28和20个月以及137、73和39个月（p <.001）。在亚组分析中，根据年龄、肾功能或治疗方案分组时，患者基于MASS有不同的OS结局。MASS在修订的ISS II期患者中识别出预后最差的患者。
在现实世界的临床实践中，MASS系统是NDMM患者可靠的风险分层工具。
