The revised international staging system compared to the classical international staging system better discriminates risk groups among transplant-ineligible multiple myeloma patients

Bila, Jelena (57208312102)Jelena (57208312102)BilaJelicic, Jelena (56180044800)Jelena (56180044800)JelicicDencic Fekete, Marija (15836938800)Marija (15836938800)Dencic FeketeTrajkovic, Goran (9739203200)Goran (9739203200)TrajkovicSretenovic, Aleksandra (24170024700)Aleksandra (24170024700)SretenovicPerunicic Jovanovic, Maja (57210906777)Maja (57210906777)Perunicic JovanovicAntic, Darko (23979576100)Darko (23979576100)AnticMihaljevic, Biljana (6701325767)Biljana (6701325767)Mihaljevic2025-06-122025-06-122017https://doi.org/10.1159/000478935https://www.scopus.com/inward/record.uri?eid=2-s2.0-85030865662&doi=10.1159%2f000478935&partnerID=40&md5=87d12f22bf22c13c086ce79c85f1cb38https://remedy.med.bg.ac.rs/handle/123456789/6753Background: The Revised International Staging System (R-ISS) has recently been introduced as a comprehensive prognostic score for multiple myeloma (MM). Validation of the R-ISS in patients treated outside of clinical trials is the focus of current investigations. The aim of this study was to test the prognostic role of the R-ISS in MM patients ineligible for autologous stem cell transplantation. Patients and Methods: A total of 102 newly diagnosed MM patients were analyzed. All patients were initially treated with thalidomide-based combinations. Results: An overall response rate was achieved in 77.4% patients. Both the International Staging System (ISS) and the R-ISS influenced the event-free survival and the overall survival (OS). However, the ISS was unable to discriminate patients in stages ISS1 and ISS2 regarding OS. On the contrary, the R-ISS clearly differentiated risk categories regarding OS and provided an improved discriminative power of 6.3% compared to the ISS. Furthermore, among the parameters that were significant in univariate analysis (presence of renal impairment, anemia, platelet count < 130 × 109/l, and R-ISS), the multivariate model pointed to the R-ISS (p = 0.001) as the most important parameter influencing OS. Conclusion: The R-ISS represents a useful tool for risk stratification of transplant-ineligible MM patients and should be considered as a prognostic index in daily clinical practice. © 2017 S. Karger GmbH, Freiburg.Multiple myelomaRevised International Staging SystemThe revised international staging system compared to the classical international staging system better discriminates risk groups among transplant-ineligible multiple myeloma patients