Combination of international scoring system 3, high lactate dehydrogenase, and t(4;14) and/or del(17p) identifies patients with multiple myeloma (MM) treated with front-line autologous stem-cell transplantation at high risk of early MM progression-related

Date publication

juillet 2014

Auteurs

Membres identifiés du Cancéropôle Est :
Dr CAILLOT Denis

Tous les auteurs :
Moreau P, Cavo M, Sonneveld P, Rosinol L, Attal M, Pezzi A, Goldschmidt H, Lahuerta JJ, Marit G, Palumbo A, van der Holt B, Blade J, Petrucci MT, Neben K, san Miguel J, Patriarca F, Lokhorst H, Zamagni E, Hulin C, Gutierrez N, Facon T, Caillot D, Benboubker L, Harousseau JL, Leleu X, Avet-Loiseau H, Mary JY

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/24888806

Résumé

PURPOSE: To construct and validate among patients with multiple myeloma (MM) who were treated with intensive therapy a prognostic index of early MM progression-related death. PATIENTS AND METHODS: Patient-level data from the Intergroupe Francophone du Myelome (IFM) 2005-01 trial (N = 482) were used to construct the prognostic index. The event was MM progression-related death within 2 years from treatment initiation. The index was validated using data from three other trials: the Gruppo Italiano Malattie Ematologiche dell' Adulto (GIMEMA) 26866138-MMY-3006 trial (N = 480), the Programa para el Estudio de la Terapeutica en Hemopatia Maligna (PETHEMA)-GEMMENOS65 trial (N = 390), and the Hemato-Oncologie voor Volwassenen Nederland (HOVON) -65/German-Speaking Myeloma Multicenter Group (GMMG) -HD4 trial (N = 827). RESULTS: The risk of early MM progression-related death was related to three independent prognostic variables: lactate dehydrogenase (LDH) higher than than normal, International Staging System 3 (ISS3), and adverse cytogenetics [t(4;14) and/or del(17p)]. These three variables enabled the definition of an ordinal prognostic classification composed of four scores (0 to 3). Patients with a score of 3, defined by the presence of t(4;14) and/or del(17p) in addition to ISS3 and/or high LDH, comprised 5% (20 of 387 patients) to 8% (94 of 1,139 patients) of the patients in the learning and validation samples, respectively, and they had a very poor prognosis. When applied to the population of 855 patients who had received bortezomib-based induction therapy in the four trials, the prognostic classification was also able to segregate patients into four categories, with a very poor prognosis attributed to patients with a score of 3. CONCLUSION: Our model allows the simple definition of a subgroup of MM patients at high risk of early MM progression-related death despite the use of the most modern and effective strategies.

Référence

J Clin Oncol. 2014 Jul 10;32(20):2173-80