Abstract

In multiple myeloma (MM), a high number of focal lesions (FL) detected using positron emission tomography/computed tomography (PET/CT) was found to be associated with adverse prognosis. To design a new risk stratification system that combines the Revised International Staging System (R-ISS) with FL, we analyzed the data of 380 patients with newly diagnosed MM (NDMM) who underwent 18F-fluorodeoxyglucose (18F-FDG) PET/CT upon diagnosis. The K-adaptive partitioning algorithm was adopted to define subgroups with homogeneous survival. The combined R-ISS with PET/CT classified NDMM patients into four groups: R-ISS/PET stage I (n = 31; R-ISS I with FL ≤ 3), stage II (n = 156; R-ISS I with FL > 3 and R-ISS II with FL ≤ 3), stage III (n = 162; R-ISS II with FL > 3 and R-ISS III with FL ≤ 3), and stage IV (n = 31; R-ISS III with FL > 3). The 2-year overall survival rates for stages I, II, III, and IV were 96.7%, 89.8%, 74.7%, and 50.3%. The 2-year progression-free survival rates were 84.1%, 64.7%, 40.8%, and 17.1%, respectively. The new R-ISS/PET was successfully validated in an external cohort. This new system had a remarkable prognostic power for estimating the survival outcomes of patients with NDMM. This system helps discriminate patients with a good prognosis from those with a poor prognosis more precisely.

Details

Title
Development of a new risk stratification system for patients with newly diagnosed multiple myeloma using R-ISS and 18F-FDG PET/CT
Author
Jeong, Cho Hee 1   VIAFID ORCID Logo  ; Sung-Hoon, Jung 2 ; Jae-Cheol, Jo 3 ; Lee Yoo Jin 3 ; Yoon, Sang Eun 4 ; Park, Sung-Soo 5   VIAFID ORCID Logo  ; Kim Do Young 6   VIAFID ORCID Logo  ; Ho-Jin, Shin 6 ; Yeung-Chul, Mun 7   VIAFID ORCID Logo  ; Yi Jun Ho 8 ; Kim Hyo Jung 9 ; Kim Da Jung 10 ; Lee, Ho Sup 10 ; Bae, Sung Hwa 11 ; Hong Chae Moon 12 ; Jeong Shin Young 12 ; Jung-Joon, Min 13 ; Sohn, Sang Kyun 1 ; Chang-Ki, Min 5 ; Kim, Kihyun 4   VIAFID ORCID Logo  ; Je-Jung, Lee 2   VIAFID ORCID Logo  ; Moon Joon Ho 1   VIAFID ORCID Logo 

1  School of Medicine, Kyungpook National University, Department of Hematology-Oncology, Kyungpook National University Hospital, Daegu, South Korea (GRID:grid.258803.4) (ISNI:0000 0001 0661 1556) 
2  Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Department of Hematology-Oncology, Hwasun-gun, South Korea (GRID:grid.411602.0) (ISNI:0000 0004 0647 9534) 
3  University of Ulsan College of Medicine, Department of Hematology and Oncology, Ulsan University Hospital, Ulsan, Korea (GRID:grid.267370.7) (ISNI:0000 0004 0533 4667) 
4  Samsung Medical Center, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, South Korea (GRID:grid.414964.a) (ISNI:0000 0001 0640 5613) 
5  College of Medicine, The Catholic University of Korea, Department of Hematology, Seoul St. Mary’s Hospital, Seoul, South Korea (GRID:grid.411947.e) (ISNI:0000 0004 0470 4224) 
6  Pusan National University School of Medicine, Department of Hematology-Oncology, Pusan National University Hospital, Busan, South Korea (GRID:grid.262229.f) (ISNI:0000 0001 0719 8572) 
7  Ewha Womans University Medical Center, Department of Hematology-Oncology, Seoul, South Korea (GRID:grid.411076.5) 
8  Chung-Ang University Hospital, Department of Hematology-Oncology, Seoul, South Korea (GRID:grid.411651.6) (ISNI:0000 0004 0647 4960) 
9  Hallym University Sacred Heart Hospital, Department of Hematology-Oncology, Anyang, South Korea (GRID:grid.488421.3) (ISNI:0000000404154154) 
10  Kosin University Gosper Hospital, Department of Hematology-Oncology, Busan, South Korea (GRID:grid.411144.5) (ISNI:0000 0004 0532 9454) 
11  Daegu Catholic University School of Medicine, Department of Hematology-Oncology, Daegu Catholic University Hospital, Daegu, South Korea (GRID:grid.411144.5) 
12  Kyungpook National University, Department of Nuclear Medicine, Kyungpook National University Hospital, School of Medicine, Daegu, South Korea (GRID:grid.258803.4) (ISNI:0000 0001 0661 1556) 
13  Chonnam National University Hwasun Hospital and Chonnam National University Medical School, Department of Nuclear Medicine, Hwasun-gun, South Korea (GRID:grid.411602.0) (ISNI:0000 0004 0647 9534) 
Publication year
2021
Publication date
Dec 2021
Publisher
Springer Nature B.V.
e-ISSN
20445385
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41408-021-00577-2
ProQuest document ID
2604981289
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.