| Evidence for cytogenetic and fluorescence in situ hybridization risk stratification of newly diagnosed multiple myeloma in the era of novel therapie. | |
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MedLine Citation:
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PMID: 20511484 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Overall survival (OS) has improved with increasing use of novel agents in multiple myeloma (MM). However, the disease course remains highly variable, and the heterogeneity largely reflects different genetic abnormalities. We studied the impact of the Mayo risk-stratification model of MM on patient outcome in the era of novel therapies, evaluating each individual component of the model-fluorescence in situ hybridization (FISH), conventional cytogenetics (CG), and the plasma cell labeling index-that segregates patients into high- and standard-risk categories. This report consists of 290 patients with newly diagnosed MM, predominantly treated with novel agents, who were risk-stratified at diagnosis and were followed up for OS. Of these patients, 81% had received primarily thalidomide (n=50), lenalidomide (n=199), or bortezomib (n=79) as frontline or salvage therapies. Our retrospective analysis validates the currently proposed Mayo risk-stratification model (median OS, 37 months vs not reached for high- and standard-risk patients, respectively; P=.003). Although the FISH or CG test identifies a high-risk cohort with hazard ratios of 2.1 (P=.006) and 2.5 (P=.006), respectively, the plasma cell labeling index cutoff of 3% fails to independently prognosticate patient risk (hazard ratio, 1.4; P=.41). In those stratified as standard-risk by one of the 2 tests (FISH or CG), the other test appears to be of additional prognostic significance. This study validates the high-risk features defined by FISH and CG in the Mayo risk-stratification model for patients with MM predominantly treated with novel therapies based on immunomodulatory agents. |
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Authors:
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Prashant Kapoor; Rafael Fonseca; S Vincent Rajkumar; Shirshendu Sinha; Morie A Gertz; A Keith Stewart; P Leif Bergsagel; Martha Q Lacy; David D Dingli; Rhett P Ketterling; Francis Buadi; Robert A Kyle; Thomas E Witzig; Philip R Greipp; Angela Dispenzieri; Shaji Kumar |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Mayo Clinic proceedings. Mayo Clinic Volume: 85 ISSN: 1942-5546 ISO Abbreviation: Mayo Clin. Proc. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-31 Completed Date: 2010-06-18 Revised Date: 2011-06-06 |
Medline Journal Info:
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Nlm Unique ID: 0405543 Medline TA: Mayo Clin Proc Country: United States |
Other Details:
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Languages: eng Pagination: 532-7 Citation Subset: AIM; IM |
Affiliation:
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Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Antineoplastic Agents / therapeutic use Boronic Acids / therapeutic use Cytogenetic Analysis* Female Humans Immunomodulation In Situ Hybridization, Fluorescence* Male Middle Aged Multiple Myeloma / diagnosis, drug therapy, genetics, mortality* Pyrazines / therapeutic use Retrospective Studies Risk Factors Salvage Therapy Thalidomide / analogs & derivatives, therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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CA107476/CA/NCI NIH HHS; CA62242/CA/NCI NIH HHS; P50 CA100707-080008/CA/NCI NIH HHS; R01 CA133115-04/CA/NCI NIH HHS; R01 CA133966-02/CA/NCI NIH HHS; R01 CA136671-02/CA/NCI NIH HHS; R01 CA136671-03/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antineoplastic Agents; 0/Boronic Acids; 0/Pyrazines; 0/bortezomib; 191732-72-6/lenalidomide; 50-35-1/Thalidomide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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