title: Combining fluorescent in situ hybridization data with ISS staging improves risk assessment in myeloma: an International Myeloma Working Group collaborative project.
abstract: The combination of serum β2-microglobulin and albumin levels has been shown to be highly prognostic in myeloma as the International Staging System (ISS). The aim of this study was to assess the independent contributions of ISS stage and cytogenetic abnormalities in predicting outcomes. A retrospective analysis of international studies looking at both ISS and cytogenetic abnormalities was performed in order to assess the potential role of combining ISS stage and cytogenetics to predict survival. This international effort used the International Myeloma Working Group database of 12 137 patients treated worldwide for myeloma at diagnosis, of whom 2309 had cytogenetic studies and 5387 had analyses by fluorescent in situ hybridization (iFISH). Comprehensive analyses used 2642 patients with sufficient iFISH data available. Using the comprehensive iFISH data, combining both t(4;14) and deletion (17p), along with ISS stage, significantly improved the prognostic assessment in terms of progression-free survival and overall survival. The additional impact of patient age and use of high-dose therapy was also demonstrated. In conclusion, the combination of iFISH data with ISS staging significantly improves risk assessment in myeloma.
authors.affiliation: Unité de Génomique du Myélome, Laboratoire UGM, University Hospital, CHU Rangueil, Toulouse, France.
authors.forename: H
authors.initials: H
authors.lastname: Avet-Loiseau
authors.forename: B G M
authors.initials: BG
authors.lastname: Durie
authors.forename: M
authors.initials: M
authors.lastname: Cavo
authors.forename: M
authors.initials: M
authors.lastname: Attal
authors.forename: N
authors.initials: N
authors.lastname: Gutierrez
authors.forename: J
authors.initials: J
authors.lastname: Haessler
authors.forename: H
authors.initials: H
authors.lastname: Goldschmidt
authors.forename: R
authors.initials: R
authors.lastname: Hajek
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: O
authors.initials: O
authors.lastname: Sezer
authors.forename: B
authors.initials: B
authors.lastname: Barlogie
authors.forename: J
authors.initials: J
authors.lastname: Crowley
authors.forename: R
authors.initials: R
authors.lastname: Fonseca
authors.forename: N
authors.initials: N
authors.lastname: Testoni
authors.forename: F
authors.initials: F
authors.lastname: Ross
authors.forename: S V
authors.initials: SV
authors.lastname: Rajkumar
authors.forename: P
authors.initials: P
authors.lastname: Sonneveld
authors.forename: J
authors.initials: J
authors.lastname: Lahuerta
authors.forename: P
authors.initials: P
authors.lastname: Moreau
authors.forename: G
authors.initials: G
authors.lastname: Morgan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007390:International Agencies; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D055815:Young Adult