TY - JOUR
T1 - Novel prognostic scoring system for autologous hematopoietic cell transplantation in multiple myeloma
AU - Dhakal, Binod
AU - D’Souza, Anita
AU - Callander, Natalie
AU - Chhabra, Saurabh
AU - Fraser, Raphael
AU - Davila, Omar
AU - Anderson, Kenneth
AU - Assal, Amer
AU - Badawy, Sherif M.
AU - Berdeja, Jesus
AU - Cerny, Jan
AU - Comenzo, Raymond
AU - Chakraborty, Rajshekhar
AU - Peter Gale, Robert
AU - Kamble, Rammurti
AU - Kharfan-Dabaja, Mohamed A.
AU - Krem, Maxwell
AU - Ganguly, Siddhartha
AU - Janakiram, Murali
AU - Kansagra, Ankit
AU - Munker, Reinhold
AU - Murthy, Hemant
AU - Patel, Sagar
AU - Kumar, Shaji
AU - Shah, Nina
AU - Qazilbash, Muzaffar
AU - Hari, Parameswaran
N1 - Publisher Copyright:
© 2020 British Society for Haematology and John Wiley & Sons Ltd
PY - 2020/11/1
Y1 - 2020/11/1
N2 - We studied 2,528 patients with upfront autologous haematopoietic cell transplantation (AHCT) for multiple myeloma (MM) from 2008–2017 to develop a prognostic model to predict outcomes. High-risk cytogenetics included t(4;14), t(14;16), t(14;20), del13q on karyotype, del17p, +1q or 1pdel. A Cox model identified factors prognostic of progression/relapse in a training subset (n = 1,246). A weighted score using these factors was assigned to a validation cohort (n = 774). Presence of high-risk cytogenetics [hazard ratio, (HR) 1·68 (1·3–2·17)] and pre-AHCT bone marrow plasma cells (BMPCs) ≥10% [1·68 (1·33–2·12)] were assigned 4 points each; albumin at diagnosis <3·5 g/dl [1·31 (1·07–1·61)] 2; standard risk cytogenetics 1, and no cytogenetics abnormality, BMPCs <10% at AHCT and albumin ≥3·5 g/dl at diagnosis 0 points each. A three-category system with low risk (0–3), intermediate risk (4–8) and high risk (9–10) showed 3-year progression-free survival in the low vs. intermediate vs. high risk of 58% (95% CI: 52–63) vs. 49% (95% CI: 43–56) vs. 31% (95% CI: 12–51), P < 0.001 respectively, and 3-year OS in low vs. intermediate vs. high risk of 88% (95% CI: 84–91) vs. 81% (95% CI: 76–86) vs. 64% (95% CI: 39–80); P < 0·001. Our prognostic scoring system can identify MM patients at risk for early relapse after AHCT.
AB - We studied 2,528 patients with upfront autologous haematopoietic cell transplantation (AHCT) for multiple myeloma (MM) from 2008–2017 to develop a prognostic model to predict outcomes. High-risk cytogenetics included t(4;14), t(14;16), t(14;20), del13q on karyotype, del17p, +1q or 1pdel. A Cox model identified factors prognostic of progression/relapse in a training subset (n = 1,246). A weighted score using these factors was assigned to a validation cohort (n = 774). Presence of high-risk cytogenetics [hazard ratio, (HR) 1·68 (1·3–2·17)] and pre-AHCT bone marrow plasma cells (BMPCs) ≥10% [1·68 (1·33–2·12)] were assigned 4 points each; albumin at diagnosis <3·5 g/dl [1·31 (1·07–1·61)] 2; standard risk cytogenetics 1, and no cytogenetics abnormality, BMPCs <10% at AHCT and albumin ≥3·5 g/dl at diagnosis 0 points each. A three-category system with low risk (0–3), intermediate risk (4–8) and high risk (9–10) showed 3-year progression-free survival in the low vs. intermediate vs. high risk of 58% (95% CI: 52–63) vs. 49% (95% CI: 43–56) vs. 31% (95% CI: 12–51), P < 0.001 respectively, and 3-year OS in low vs. intermediate vs. high risk of 88% (95% CI: 84–91) vs. 81% (95% CI: 76–86) vs. 64% (95% CI: 39–80); P < 0·001. Our prognostic scoring system can identify MM patients at risk for early relapse after AHCT.
KW - AHCT
KW - MM
KW - prognostic scoring system
UR - https://www.scopus.com/pages/publications/85088463591
U2 - 10.1111/bjh.16987
DO - 10.1111/bjh.16987
M3 - Article
C2 - 33094839
AN - SCOPUS:85088463591
SN - 0007-1048
VL - 191
SP - 442
EP - 452
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 3
ER -