New Characteristics Identified for Poor Prognosis in Standard-Risk Multiple Myeloma

12/30/17

A recent study identified patient characteristics that help predict poor 3-year survival in newly diagnosed standard-risk multiple myeloma.

Results of the study were published at the American Society of Hematology (ASH) Annual Meeting and Exposition (December 8-12, 2017; Atlanta, GA).

A subset of patients with newly diagnosed multiple myeloma experience poor overall survival, despite the absence of cytogenetic high-risk abnormalities in fluorescence in situ hybridization (FISH) evaluation. However, characteristics that would help explain this poor survival trend are in need of further research.

Moritz Binder, MD, MPH, division of hematology, Mayo Clinic (Rochester, MN), and colleagues designed a study aimed at identifying demographic, clinical, and cytogenetic characteristics that predict poor 3-year overall survival in patients with such disease. A total of 428 patients diagnosed between 2004 and 2014 were sampled, all of whom underwent FISH evaluation within 6 months of diagnosis and received treatment with novel agents.

High-risk cytogenetics were defined as del(17p), t(14;16), and t(14;20). Intermediate-risk cytogenetics were defined as t(4;14) and dup(1q).

Researchers reported a median overall survival of 7.4 years for the entire cohort, 10.5 years for those who survived a minimum of 3 years (n = 327), and 1.6 years  for those who did not survive 3 years after diagnosis (n = 101).

Among the factors found to correlate with poor 3-year overall survival included age higher than 60 years, advanced-stage disease, thrombocytopenia, absence of trisomies on FISH, and low bone marrow plasma cells.

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Results of the study led Dr Binder and colleagues to come to three verifiable conclusions:

  • Patients with standard-risk multiple myeloma are a heterogeneous population.
  • Twenty-five percent of patients are experiencing less than 3 years of overall survival after diagnosis.
  • Five readily available factors are helpful in identifying patients at risk for early death.

“These findings emphasize the importance of further risk stratification in this patient population and warrant external validation,” they wrote.—Zachary Bessette