Li Ye, Liu Junru, Deng Jingjing, Jian Yuan, Zhang Zhiyao, Zhou Huixing, Li Juan, Chen Wenming
Department of Hematology, Myeloma Research Center of Beijing, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for Hematological Diseases, Beijing, China.
Front Med (Lausanne). 2024 Oct 22;11:1473034. doi: 10.3389/fmed.2024.1473034. eCollection 2024.
We developed a new predictive staging system to explore the heterogeneity of survival in newly diagnosed multiple myeloma (NDMM) patients in the real world.
In this retrospective study, we evaluated the predictive value of cytogenetic abnormal and clinical data in 375 patients with NDMM at our center. Established a weighted MM prognostic scoring system risk model and validated its predicted PFS and OS by external cohort.
Elevated lactate dehydrogenase levels (1 point), international staging system stage II/III (1 point), 1q21+ ≥ 52.75% (0.5 point), del (17p) ≥ 3.5% (0.5 point), and t (14;16) ≥ 35.25% (1 point) had independent prognostic significance. Patients were further divided into three risk groups: low (I) (score 0-0.5, 16.5%), intermediate (II) (score 1, 46.7%), and high (III) (score 1.5-3, 36.8%). In the training cohort, the 3-year PFS was 79.5% vs. 65.3% vs. 40.3% ( < 0.001), and the 3-year OS was 87.7% vs.70.1% vs. 55% ( < 0.001) for the three risk groups. In the external validation cohort, the 3-year PFS was 85.5% vs.61.2% vs. 43.1% ( < 0.001) and the 3-year OS was 91.4% vs.83.5% vs. 56.9% ( < 0.001) for the three risk groups.
The risk stratification of this model shows good discrimination and calibration, and its application in clinical practice can improve the risk assessment of patients with NDMM and guide personalized treatment strategies.
我们开发了一种新的预测分期系统，以探索现实世界中初诊多发性骨髓瘤（NDMM）患者生存的异质性。
在这项回顾性研究中，我们评估了375例在本中心的NDMM患者的细胞遗传学异常和临床数据的预测价值。建立了加权MM预后评分系统风险模型，并通过外部队列验证其预测的无进展生存期（PFS）和总生存期（OS）。
乳酸脱氢酶水平升高（1分）、国际分期系统II/III期（1分）、1q21+≥52.75%（0.5分）、del(17p)≥3.5%（0.5分）和t(14;16)≥35.25%（1分）具有独立的预后意义。患者进一步分为三个风险组：低风险（I）组（评分0 - 0.5，16.5%）、中风险（II）组（评分1，46.7%）和高风险（III）组（评分1.5 - 3，36.8%）。在训练队列中，三个风险组的3年PFS分别为79.5%、65.3%和40.3%（P<0.001），3年OS分别为87.7%、70.1%和55%（P<0.001）。在外部验证队列中，三个风险组的3年PFS分别为85.5%、61.2%和43.1%（P<0.001），3年OS分别为91.4%、83.5%和56.9%（P<0.001）。
该模型的风险分层显示出良好的区分度和校准度，其在临床实践中的应用可以改善NDMM患者的风险评估并指导个性化治疗策略。
