title: Consensus recommendations for risk stratification in multiple myeloma: report of the International Myeloma Workshop Consensus Panel 2.
abstract: A panel of members of the 2009 International Myeloma Workshop developed guidelines for risk stratification in multiple myeloma. The purpose of risk stratification is not to decide time of therapy but to prognosticate. There is general consensus that risk stratification is applicable to newly diagnosed patients; however, some genetic abnormalities characteristic of poor outcome at diagnosis may suggest poor outcome if only detected at the time of relapse. Thus, in good-risk patients, it is necessary to evaluate for high-risk features at relapse. Although detection of any cytogenetic abnormality is considered to suggest higher-risk disease, the specific abnormalities considered as poor risk are cytogenetically detected chromosomal 13 or 13q deletion, t(4;14) and del17p, and detection by fluorescence in situ hybridization of t(4;14), t(14;16), and del17p. Detection of 13q deletion by fluorescence in situ hybridization only, in absence of other abnormalities, is not considered a high-risk feature. High serum β(2)-microglobulin level and International Staging System stages II and III, incorporating high β(2)-microglobulin and low albumin, are considered to predict higher risk disease. There was a consensus that the high-risk features will change in the future, with introduction of other new agents or possibly new combinations.
authors.affiliation: Dana-Farber Cancer Institute, Boston, MA, USA. nikhil_munshi@dfci.harvard.edu
authors.forename: Nikhil C
authors.initials: NC
authors.lastname: Munshi
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Anderson
authors.forename: P Leif
authors.initials: PL
authors.lastname: Bergsagel
authors.forename: John
authors.initials: J
authors.lastname: Shaughnessy
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Brian
authors.initials: B
authors.lastname: Durie
authors.forename: Rafael
authors.initials: R
authors.lastname: Fonseca
authors.forename: A Keith
authors.initials: AK
authors.lastname: Stewart
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Harousseau
authors.forename: Meletios
authors.initials: M
authors.lastname: Dimopoulos
authors.forename: Sundar
authors.initials: S
authors.lastname: Jagannath
authors.forename: Roman
authors.initials: R
authors.lastname: Hajek
authors.forename: Orhan
authors.initials: O
authors.lastname: Sezer
authors.forename: Robert
authors.initials: R
authors.lastname: Kyle
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.forename: Jesus
authors.initials: J
authors.lastname: San Miguel
authors.forename: John
authors.initials: J
authors.lastname: Crowley
authors.forename: Hervé
authors.initials: H
authors.lastname: Avet-Loiseau
mesh_terms: D002869:Chromosome Aberrations; D020869:Gene Expression Profiling; D006801:Humans; D009101:Multiple Myeloma / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D009367:Neoplasm Staging; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors