Heterogeneity in long-term outcomes for R-ISS stage II in newly diagnosed multiple myeloma patients

Multiple myeloma (MM) is characterized by clonal accumulation of plasma cells in the bone marrow. Despite considerable progress in patients’ treatment, patient prognosis remains very heterogeneous. The International Myeloma Working Group recommends using the Revised International Staging System (R-ISS) to stratify and identify high-risk patients. In this study, we have shown the wide heterogeneity of outcomes in the R-ISS stage II group (intermediate-risk class). Stratification of these patients can be improved by dividing them according to their cytogenetics abnormalities and biochemical markers (ISS score: albumine and β2-microglobulin). In the era of personalized treatment in MM, high-risk patients must be accurately defined. We believe that an oversimplified score cannot achieve this and that we should take into account the additional weight of cytogenetics, genomics and also longitudinally biomarkers (residual disease status, imaging).

This work questions the accuracy of the international prognostic score R-ISS and raises the interest of new more efficient scores such as the LP score, developed by our team, and based only on cytogenetic abnormalities.

Collaborations and acknowledgements

Nous remercions l’Intergroupe Francophone du Myélome (IFM) pour avoir fourni les échantillons des patients et leurs données cliniques, avec un remerciement spécial pour Sandrine Rollet.