1. Novel prognostic scoring system for autologous hematopoietic cell transplantation in multiple myeloma.
- Author
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Dhakal, Binod, D'Souza, Anita, Callander, Natalie, Chhabra, Saurabh, Fraser, Raphael, Davila, Omar, Anderson, Kenneth, Assal, Amer, Badawy, Sherif M., Berdeja, Jesus, Cerny, Jan, Comenzo, Raymond, Chakraborty, Rajshekhar, Peter Gale, Robert, Kamble, Rammurti, Kharfan‐Dabaja, Mohamed A., Krem, Maxwell, Ganguly, Siddhartha, Janakiram, Murali, and Kansagra, Ankit
- Subjects
CELL transplantation ,MULTIPLE myeloma ,HEMATOPOIETIC system ,BONE marrow cells ,PROGNOSIS - Abstract
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. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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