Evaluation of the R2‐ISS in real‐world patients with newly diagnosed multiple myeloma: A nationwide cohort study by the Korean Multiple Myeloma Working Party (KMM 2202)

• Published in: HemaSphere 2024-01, Vol.8 (1), p.e33-n/a
• Main Authors: Cho, Hyungwoo, Kim, Kihyun, Yoon, Sang Eun, Jung, Sung‐Hoon, Lee, Je‐Jung, Moon, Joon Ho, Cho, Hee Jeong, Lee, Ho Sup, Kang, Ka‐Won, Kim, Sung‐Yong, Eom, Hyeon‐Seok, Mun, Yeung‐Chul, Park, Young Hoon, Yoon, Sung‐Soo, Do, Young Rok, Lee, Won Sik, Min, Chang‐Ki, Yoon, Dok Hyun
• Format: Article
• Language: English
• Subjects: Clinical medicine; Clinical trials; Creatinine; Multiple myeloma; Participation
• ISSN: 2572-9241; 2572-9241
• DOI: 10.1002/hem3.33

Multiple myeloma (MM) is a plasma cell neoplasm with significant variability in survival outcomes due to its complex and heterogeneous nature. [...]the development of an accurate prognostic model is crucial in clinical practice to guide treatment decisions, predict disease outcomes, and inform patients. Yet, it is important to note that the development and validation of the R2-ISS were primarily based on patients enrolled in clinical trials, which often exclude individuals with comorbidities and poor performance status. [...]the objective of our study (KMM 2202) is to validate the R2-ISS in an independent cohort of patients from real-world clinical practice and compare its performance to that of the R-ISS. Characteristics Total patients (n = 572) Age at diagnosis (years) 63 (36–88) UNL 151 (26.4%) Serum creatinine ≤2 mg/dL 446 (78.0%) >2 mg/dL 126 (22.0%) Del(17p) No 533 (93.2%) Yes 39 (6.8%) t(4;14) No 491 (85.8%) Yes 81 (14.2%) t(4;16) No 536 (93.7%) Yes 32 (5.6%) Not available 4 (0.7%) 1q gain or amplification No 455 (79.5%) Yes 117 (20.5%) First-line treatment IMiDs 254 (44.4%) PIs 241 (42.1%) IMiD-PIs 77 (13.5%) Upfront ASCT No 334 (58.4%) Yes 238 (41.6%) There was a significant difference in both PFS and OS among the R-ISS groups. Despite these notable differences from the original EMN cohort, the R2-ISS demonstrated consistent prognostic power in our patients. [...]R2-ISS effectively stratified patients with distinct survival outcomes across different age groups (elderly and young patients) and among those treated with PIs, IMiDs, or IMiDs plus PIs.