Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation: The Revised International Staging System Shows the Most Differentiation between Groups

Emma C. Scott; Parameswaran Hari; Sathish Kumar; Raphael Fraser; Omar Davila; Nina Shah; Robert Peter Gale; Miguel Angel Diaz; Vaibhav Agrawal; Robert F. Cornell; Siddhartha Ganguly; Gorgun Akpek; Cesar Freytes; Shahrukh Hashmi; Ehsan Malek; Rammurti T. Kamble; Hillard Lazarus; Melhem Solh; Saad Z. Usmani; Abraham S. Kanate; Ayman Saad; Saurabh Chhabra; Usama Gergis; Jan Cerny; Robert A. Kyle; Cindy Lee; Tamila Kindwall-Keller; Amer Assal; Gerhard C. Hildebrandt; Leona Holmberg; Richard T. Maziarz; Taiga Nishihori; Sachiko Seo; Shaji Kumar; Tomer Mark; Anita D'Souza

doi:10.1016/j.bbmt.2018.08.013

Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation: The Revised International Staging System Shows the Most Differentiation between Groups

Emma C. Scott, Parameswaran Hari, Sathish Kumar, Raphael Fraser, Omar Davila, Nina Shah, Robert Peter Gale, Miguel Angel Diaz, Vaibhav Agrawal, Robert F. Cornell, Siddhartha Ganguly, Gorgun Akpek, Cesar Freytes, Shahrukh Hashmi, Ehsan Malek, Rammurti T. Kamble, Hillard Lazarus, Melhem Solh, Saad Z. Usmani, Abraham S. KanateAyman Saad, Saurabh Chhabra, Usama Gergis, Jan Cerny, Robert A. Kyle, Cindy Lee, Tamila Kindwall-Keller, Amer Assal, Gerhard C. Hildebrandt, Leona Holmberg, Richard T. Maziarz, Taiga Nishihori, Sachiko Seo, Shaji Kumar, Tomer Mark, Anita D'Souza

Internal Medicine

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

The Revised International Staging System (R-ISS) and the International Myeloma Working Group 2014 (IMWG 2014) are newer staging systems used to prognosticate multiple myeloma (MM) outcomes. We hypothesized that these would provide better prognostic differentiation for newly diagnosed multiple myeloma (MM) compared with ISS. We analyzed the Center for International Blood and Marrow Transplant Research database from 2008 to 2014 to compare the 3 systems (N = 628) among newly diagnosed MM patients undergoing upfront autologous hematopoietic cell transplantation (AHCT). The median follow-up of survivors was 48 (range, 3 to 99) months. The R-ISS provided the greatest differentiation between survival curves for each stage (for overall survival [OS], the differentiation was 1.74 using the R-ISS, 1.58 using ISS, and 1.60 using the IMWG 2014). Univariate analyses at 3 years for OS showed R-ISS I at 88% (95% confidence interval [CI], 83% to 93%), II at 75% (95% CI, 70% to 80%), and III at 56% (95% CI, 3% to 69%; P <.001). An integrated Brier score function demonstrated the R-ISS had the best prediction for PFS, though all systems had similar prediction for OS. Among available systems, the R-ISS is the most optimal among available prognostic tools for newly diagnosed MM undergoing AHCT. We recommend that serum lactate dehydrogenase and cytogenetic data be performed on every MM patient at diagnosis to allow accurate prognostication.

Original language	English
Pages (from-to)	2443-2449
Number of pages	7
Journal	Biology of Blood and Marrow Transplantation
Volume	24
Issue number	12
DOIs	https://doi.org/10.1016/j.bbmt.2018.08.013
State	Published - Dec 2018

Bibliographical note

Publisher Copyright:
© 2018

Funding

Financial Disclosure: The Center for International Blood and Marrow Transplant Research is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute, the National Heart, Lung and Blood Institute, and the National Institute of Allergy and Infectious Diseases; a grant/cooperative agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH25020170006C with Health Resources and Services Administration (Department of Health and Human Services); 2 grants (N00014-17-1-2388 and N0014-17-1-2850) from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angiocrine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Janssen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. – Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick's Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration, or any other agency of the U.S. Government. Financial Disclosure: The Center for International Blood and Marrow Transplant Research is supported primarily by Public Health Service Grant/Cooperative Agreement 5U24CA076518 from the National Cancer Institute, the National Heart, Lung and Blood Institute, and the National Institute of Allergy and Infectious Diseases; a grant/cooperative agreement 4U10HL069294 from NHLBI and NCI; a contract HHSH25020170006C with Health Resources and Services Administration (Department of Health and Human Services); 2 grants (N00014-17-1-2388 and N0014-17-1-2850) from the Office of Naval Research; and grants from *Actinium Pharmaceuticals, Inc.; *Amgen, Inc.; *Amneal Biosciences; *Angiocrine Bioscience, Inc.; Anonymous donation to the Medical College of Wisconsin; Astellas Pharma US; Atara Biotherapeutics, Inc.; Be the Match Foundation; *bluebird bio, Inc.; *Bristol Myers Squibb Oncology; *Celgene Corporation; Cerus Corporation; *Chimerix, Inc.; Fred Hutchinson Cancer Research Center; Gamida Cell Ltd.; Gilead Sciences, Inc.; HistoGenetics, Inc.; Immucor; *Incyte Corporation; Janssen Scientific Affairs, LLC; *Jazz Pharmaceuticals, Inc.; Juno Therapeutics; Karyopharm Therapeutics, Inc.; Kite Pharma, Inc.; Medac, GmbH; MedImmune; The Medical College of Wisconsin; *Mediware; *Merck & Co, Inc.; *Mesoblast; MesoScale Diagnostics, Inc.; Millennium, the Takeda Oncology Co.; *Miltenyi Biotec, Inc.; National Marrow Donor Program; *Neovii Biotech NA, Inc.; Novartis Pharmaceuticals Corporation; Otsuka Pharmaceutical Co, Ltd. ? Japan; PCORI; *Pfizer, Inc; *Pharmacyclics, LLC; PIRCHE AG; *Sanofi Genzyme; *Seattle Genetics; Shire; Spectrum Pharmaceuticals, Inc.; St. Baldrick's Foundation; *Sunesis Pharmaceuticals, Inc.; Swedish Orphan Biovitrum, Inc.; Takeda Oncology; Telomere Diagnostics, Inc.; and University of Minnesota. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration, or any other agency of the U.S. Government. Conflict of Interest Statement: There are no conflicts of interest to report.

Funders	Funder number
Actinium Pharmaceuticals, Inc.
AMGEN, Inc.
Amneal Biosciences, *Angiocrine Bioscience
Angiocrine Bioscience, Inc.
Department of the Navy
National Institute of Health National Institute of Minority and Health Disparities Loan Repayment Program
U.S. Government
U.S. Department of Defense
Office of Naval Research Naval Academy
U.S. Department of Health and Human Services	N00014-17-1-2388, N0014-17-1-2850
National Heart, Lung, and Blood Institute (NHLBI)
National Childhood Cancer Registry – National Cancer Institute	U24CA076518, HHSH25020170006C
National Institute of Allergy and Infectious Diseases	4U10HL069294
Health Resources and Services Administration
AMGen
Minnesota State University-Mankato
Actinium Pharmaceuticals Incorporated
Angiocrine Bioscience

Keywords

International staging system
Revised international staging system
Staging system comparison

ASJC Scopus subject areas

Hematology
Transplantation

Access to Document

10.1016/j.bbmt.2018.08.013

Cite this

Scott, E. C., Hari, P., Kumar, S., Fraser, R., Davila, O., Shah, N., Gale, R. P., Diaz, M. A., Agrawal, V., Cornell, R. F., Ganguly, S., Akpek, G., Freytes, C., Hashmi, S., Malek, E., Kamble, R. T., Lazarus, H., Solh, M., Usmani, S. Z., ... D'Souza, A. (2018). Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation: The Revised International Staging System Shows the Most Differentiation between Groups. Biology of Blood and Marrow Transplantation, 24(12), 2443-2449. https://doi.org/10.1016/j.bbmt.2018.08.013

@article{bf29f329cabd4b63808ea89886b70cc8,

title = "Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation: The Revised International Staging System Shows the Most Differentiation between Groups",

abstract = "The Revised International Staging System (R-ISS) and the International Myeloma Working Group 2014 (IMWG 2014) are newer staging systems used to prognosticate multiple myeloma (MM) outcomes. We hypothesized that these would provide better prognostic differentiation for newly diagnosed multiple myeloma (MM) compared with ISS. We analyzed the Center for International Blood and Marrow Transplant Research database from 2008 to 2014 to compare the 3 systems (N = 628) among newly diagnosed MM patients undergoing upfront autologous hematopoietic cell transplantation (AHCT). The median follow-up of survivors was 48 (range, 3 to 99) months. The R-ISS provided the greatest differentiation between survival curves for each stage (for overall survival [OS], the differentiation was 1.74 using the R-ISS, 1.58 using ISS, and 1.60 using the IMWG 2014). Univariate analyses at 3 years for OS showed R-ISS I at 88\% (95\% confidence interval [CI], 83\% to 93\%), II at 75\% (95\% CI, 70\% to 80\%), and III at 56\% (95\% CI, 3\% to 69\%; P <.001). An integrated Brier score function demonstrated the R-ISS had the best prediction for PFS, though all systems had similar prediction for OS. Among available systems, the R-ISS is the most optimal among available prognostic tools for newly diagnosed MM undergoing AHCT. We recommend that serum lactate dehydrogenase and cytogenetic data be performed on every MM patient at diagnosis to allow accurate prognostication.",

keywords = "International staging system, Revised international staging system, Staging system comparison",

author = "Scott, \{Emma C.\} and Parameswaran Hari and Sathish Kumar and Raphael Fraser and Omar Davila and Nina Shah and Gale, \{Robert Peter\} and Diaz, \{Miguel Angel\} and Vaibhav Agrawal and Cornell, \{Robert F.\} and Siddhartha Ganguly and Gorgun Akpek and Cesar Freytes and Shahrukh Hashmi and Ehsan Malek and Kamble, \{Rammurti T.\} and Hillard Lazarus and Melhem Solh and Usmani, \{Saad Z.\} and Kanate, \{Abraham S.\} and Ayman Saad and Saurabh Chhabra and Usama Gergis and Jan Cerny and Kyle, \{Robert A.\} and Cindy Lee and Tamila Kindwall-Keller and Amer Assal and Hildebrandt, \{Gerhard C.\} and Leona Holmberg and Maziarz, \{Richard T.\} and Taiga Nishihori and Sachiko Seo and Shaji Kumar and Tomer Mark and Anita D'Souza",

note = "Publisher Copyright: {\textcopyright} 2018",

year = "2018",

month = dec,

doi = "10.1016/j.bbmt.2018.08.013",

language = "English",

volume = "24",

pages = "2443--2449",

number = "12",

}

Scott, EC, Hari, P, Kumar, S, Fraser, R, Davila, O, Shah, N, Gale, RP, Diaz, MA, Agrawal, V, Cornell, RF, Ganguly, S, Akpek, G, Freytes, C, Hashmi, S, Malek, E, Kamble, RT, Lazarus, H, Solh, M, Usmani, SZ, Kanate, AS, Saad, A, Chhabra, S, Gergis, U, Cerny, J, Kyle, RA, Lee, C, Kindwall-Keller, T, Assal, A, Hildebrandt, GC, Holmberg, L, Maziarz, RT, Nishihori, T, Seo, S, Kumar, S, Mark, T & D'Souza, A 2018, 'Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation: The Revised International Staging System Shows the Most Differentiation between Groups', Biology of Blood and Marrow Transplantation, vol. 24, no. 12, pp. 2443-2449. https://doi.org/10.1016/j.bbmt.2018.08.013

Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation: The Revised International Staging System Shows the Most Differentiation between Groups. / Scott, Emma C.; Hari, Parameswaran; Kumar, Sathish et al.
In: Biology of Blood and Marrow Transplantation, Vol. 24, No. 12, 12.2018, p. 2443-2449.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation

T2 - The Revised International Staging System Shows the Most Differentiation between Groups

AU - Scott, Emma C.

AU - Hari, Parameswaran

AU - Kumar, Sathish

AU - Fraser, Raphael

AU - Davila, Omar

AU - Shah, Nina

AU - Gale, Robert Peter

AU - Diaz, Miguel Angel

AU - Agrawal, Vaibhav

AU - Cornell, Robert F.

AU - Ganguly, Siddhartha

AU - Akpek, Gorgun

AU - Freytes, Cesar

AU - Hashmi, Shahrukh

AU - Malek, Ehsan

AU - Kamble, Rammurti T.

AU - Lazarus, Hillard

AU - Solh, Melhem

AU - Usmani, Saad Z.

AU - Kanate, Abraham S.

AU - Saad, Ayman

AU - Chhabra, Saurabh

AU - Gergis, Usama

AU - Cerny, Jan

AU - Kyle, Robert A.

AU - Lee, Cindy

AU - Kindwall-Keller, Tamila

AU - Assal, Amer

AU - Hildebrandt, Gerhard C.

AU - Holmberg, Leona

AU - Maziarz, Richard T.

AU - Nishihori, Taiga

AU - Seo, Sachiko

AU - Kumar, Shaji

AU - Mark, Tomer

AU - D'Souza, Anita

PY - 2018/12

Y1 - 2018/12

N2 - The Revised International Staging System (R-ISS) and the International Myeloma Working Group 2014 (IMWG 2014) are newer staging systems used to prognosticate multiple myeloma (MM) outcomes. We hypothesized that these would provide better prognostic differentiation for newly diagnosed multiple myeloma (MM) compared with ISS. We analyzed the Center for International Blood and Marrow Transplant Research database from 2008 to 2014 to compare the 3 systems (N = 628) among newly diagnosed MM patients undergoing upfront autologous hematopoietic cell transplantation (AHCT). The median follow-up of survivors was 48 (range, 3 to 99) months. The R-ISS provided the greatest differentiation between survival curves for each stage (for overall survival [OS], the differentiation was 1.74 using the R-ISS, 1.58 using ISS, and 1.60 using the IMWG 2014). Univariate analyses at 3 years for OS showed R-ISS I at 88% (95% confidence interval [CI], 83% to 93%), II at 75% (95% CI, 70% to 80%), and III at 56% (95% CI, 3% to 69%; P <.001). An integrated Brier score function demonstrated the R-ISS had the best prediction for PFS, though all systems had similar prediction for OS. Among available systems, the R-ISS is the most optimal among available prognostic tools for newly diagnosed MM undergoing AHCT. We recommend that serum lactate dehydrogenase and cytogenetic data be performed on every MM patient at diagnosis to allow accurate prognostication.

AB - The Revised International Staging System (R-ISS) and the International Myeloma Working Group 2014 (IMWG 2014) are newer staging systems used to prognosticate multiple myeloma (MM) outcomes. We hypothesized that these would provide better prognostic differentiation for newly diagnosed multiple myeloma (MM) compared with ISS. We analyzed the Center for International Blood and Marrow Transplant Research database from 2008 to 2014 to compare the 3 systems (N = 628) among newly diagnosed MM patients undergoing upfront autologous hematopoietic cell transplantation (AHCT). The median follow-up of survivors was 48 (range, 3 to 99) months. The R-ISS provided the greatest differentiation between survival curves for each stage (for overall survival [OS], the differentiation was 1.74 using the R-ISS, 1.58 using ISS, and 1.60 using the IMWG 2014). Univariate analyses at 3 years for OS showed R-ISS I at 88% (95% confidence interval [CI], 83% to 93%), II at 75% (95% CI, 70% to 80%), and III at 56% (95% CI, 3% to 69%; P <.001). An integrated Brier score function demonstrated the R-ISS had the best prediction for PFS, though all systems had similar prediction for OS. Among available systems, the R-ISS is the most optimal among available prognostic tools for newly diagnosed MM undergoing AHCT. We recommend that serum lactate dehydrogenase and cytogenetic data be performed on every MM patient at diagnosis to allow accurate prognostication.

KW - International staging system

KW - Revised international staging system

KW - Staging system comparison

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UR - http://www.scopus.com/inward/citedby.url?scp=85054709914&partnerID=8YFLogxK

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DO - 10.1016/j.bbmt.2018.08.013

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AN - SCOPUS:85054709914

SN - 1083-8791

VL - 24

SP - 2443

EP - 2449

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

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ER -

Staging Systems for Newly Diagnosed Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation: The Revised International Staging System Shows the Most Differentiation between Groups

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

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