PMID- 32442300
OWN - NLM
STAT- MEDLINE
DCOM- 20210514
LR  - 20210925
IS  - 2473-9537 (Electronic)
IS  - 2473-9529 (Print)
IS  - 2473-9529 (Linking)
VI  - 4
IP  - 10
DP  - 2020 May 26
TI  - Metaphase cytogenetics and plasma cell proliferation index for risk 
      stratification in newly diagnosed multiple myeloma.
PG  - 2236-2244
LID - 10.1182/bloodadvances.2019001275 [doi]
AB  - Metaphase cytogenetic abnormalities, plasma cell proliferation index (PCPro), and 
      gain 1q by fluorescence in situ hybridization (FISH) are associated with inferior 
      survival in newly diagnosed multiple myeloma (MM) treated with novel agents; 
      however, their role in risk stratification is unclear in the era of the revised 
      International Staging System (R-ISS). The objective of this study was to 
      determine if these predictors improve risk stratification in newly diagnosed MM 
      when accounting for R-ISS and age. We studied a retrospective cohort of 483 
      patients with newly diagnosed MM treated with proteasome inhibitors and/or 
      immunomodulators. On multivariable analysis, R-ISS, age, metaphase cytogenetic 
      abnormalities (both in aggregate and for specific abnormalities), PCPro, and FISH 
      gain 1q were associated with inferior progression-free (PFS) and overall survival 
      (OS). We devised a risk scoring system based on hazard ratios from multivariable 
      analyses and assigned patients to low-, intermediate-, and high-risk groups based 
      on their cumulative scores. The addition of metaphase cytogenetic abnormalities, 
      PCPro, and FISH gain 1q to a risk scoring system accounting for R-ISS and age did 
      not improve risk discrimination of Kaplan-Meier estimates for PFS or OS. 
      Moreover, they did not improve prognostic performance when evaluated by Uno's 
      censoring-adjusted C-statistic. Lastly, we performed a paired analysis of 
      metaphase cytogenetic and interphase FISH abnormalities, which revealed the 
      former to be insensitive for the detection of prognostic chromosomal 
      abnormalities. Ultimately, metaphase cytogenetics lack sensitivity for important 
      chromosomal aberrations and, along with PCPro and FISH gain 1q, do not improve 
      risk stratification in MM when accounting for R-ISS and age.
CI  - (c) 2020 by The American Society of Hematology.
FAU - Mellors, Patrick W
AU  - Mellors PW
AD  - Department of Internal Medicine.
FAU - Binder, Moritz
AU  - Binder M
AD  - Division of Hematology, and.
FAU - Ketterling, Rhett P
AU  - Ketterling RP
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
FAU - Greipp, Patricia T
AU  - Greipp PT
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
FAU - Baughn, Linda B
AU  - Baughn LB
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
FAU - Peterson, Jess F
AU  - Peterson JF
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
FAU - Jevremovic, Dragan
AU  - Jevremovic D
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
FAU - Pearce, Kathryn E
AU  - Pearce KE
AD  - Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
FAU - Buadi, Francis K
AU  - Buadi FK
AD  - Division of Hematology, and.
FAU - Lacy, Martha Q
AU  - Lacy MQ
AD  - Division of Hematology, and.
FAU - Gertz, Morie A
AU  - Gertz MA
AD  - Division of Hematology, and.
FAU - Dispenzieri, Angela
AU  - Dispenzieri A
AD  - Division of Hematology, and.
FAU - Hayman, Suzanne R
AU  - Hayman SR
AD  - Division of Hematology, and.
FAU - Kapoor, Prashant
AU  - Kapoor P
AD  - Division of Hematology, and.
FAU - Gonsalves, Wilson I
AU  - Gonsalves WI
AD  - Division of Hematology, and.
FAU - Hwa, Yi L
AU  - Hwa YL
AD  - Division of Hematology, and.
FAU - Fonder, Amie
AU  - Fonder A
AD  - Division of Hematology, and.
FAU - Hobbs, Miriam
AU  - Hobbs M
AD  - Division of Hematology, and.
FAU - Kourelis, Taxiarchis
AU  - Kourelis T
AD  - Division of Hematology, and.
FAU - Warsame, Rahma
AU  - Warsame R
AD  - Division of Hematology, and.
FAU - Lust, John A
AU  - Lust JA
AD  - Division of Hematology, and.
FAU - Leung, Nelson
AU  - Leung N
AD  - Division of Hematology, and.
FAU - Go, Ronald S
AU  - Go RS
AD  - Division of Hematology, and.
FAU - Kyle, Robert A
AU  - Kyle RA
AD  - Division of Hematology, and.
FAU - Rajkumar, S Vincent
AU  - Rajkumar SV
AD  - Division of Hematology, and.
FAU - Kumar, Shaji K
AU  - Kumar SK
AD  - Division of Hematology, and.
LA  - eng
GR  - P50 CA186781/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Blood Adv
JT  - Blood advances
JID - 101698425
SB  - IM
MH  - Cell Proliferation
MH  - Cytogenetic Analysis
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Metaphase
MH  - *Multiple Myeloma/diagnosis/genetics
MH  - Retrospective Studies
MH  - Risk Assessment
PMC - PMC7252538
COIS- Conflict-of-interest disclosure: The authors declare no competing financial 
      interests.
EDAT- 2020/05/23 06:00
MHDA- 2021/05/15 06:00
PMCR- 2020/05/22
CRDT- 2020/05/23 06:00
PHST- 2019/11/27 00:00 [received]
PHST- 2020/04/15 00:00 [accepted]
PHST- 2020/05/23 06:00 [entrez]
PHST- 2020/05/23 06:00 [pubmed]
PHST- 2021/05/15 06:00 [medline]
PHST- 2020/05/22 00:00 [pmc-release]
AID - S2473-9529(20)31299-4 [pii]
AID - 2019/ADV2019001275 [pii]
AID - 10.1182/bloodadvances.2019001275 [doi]
PST - ppublish
SO  - Blood Adv. 2020 May 26;4(10):2236-2244. doi: 10.1182/bloodadvances.2019001275.