Critical Study of Staging in Multiple Myeloma

Pennec, Y; Mottier, Dominique; Youinou, Pierre; Asselain, Bernard; Chavance, Michel; Goff, P. Le; Prise, Pierre-Yves Le; Miossec, Pierre; Menn, G. Le

doi:10.1111/j.1600-0609.1983.tb01468.x

Cited by 23 publications

(4 citation statements)

References 19 publications

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“…Out of the remaining parameters investigated, only age and platelet count proved to be reliable predictors of prognosis, the latter feature at the same discriminant (i.e. 150 x 109/1) identified in several previous studies (15,16).…”

Section: Discussionsupporting

confidence: 64%

Improvement of Durie & Salmon staging for multiple myeloma by adding platelet count as a stratifying variable: A multivariate regression analysis of 163 untreated patients

Cavo

Galieni

Grimaldi

et al. 1989

European J of Haematology

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The presenting clinical features of 163 previously untreated patients with multiple myeloma were correlated with survival duration using univariate and multivariate regression analyses. The univariate proportional hazard analysis ranked the parameters in the following order of importance: platelet count, haemoglobin level (Hb), tumour cell mass stage, lytic bone lesions, creatinine and age. When the individual contribution of each variable was assessed by multivarite regression analysis, platelet count was confirmed to be the dominant feature for prognosis, while clinical stage provided additional information. The introduction of platelet count could then be used to improve the discriminating power of Durie & Salmon staging, by allowing separation of the high‐risk group (stages II and III) into a smaller subgroup (22%) of thrombocytopenic patients (< 150 × 109 platelets/l) whose risk of death was actually very high (median survival: 9 months) and a larger subgroup (46%) of patients with normal platelet count and intermediate or standard risk (median survival: 48 months).

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Section: Discussionsupporting

confidence: 64%

Improvement of Durie & Salmon staging for multiple myeloma by adding platelet count as a stratifying variable: A multivariate regression analysis of 163 untreated patients

Cavo

Galieni

Grimaldi

et al. 1989

European J of Haematology

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“…These findings are in agreement with those of Woodruff and coworkers (4). The results of Pennec et al were in the same direction but did not reach statistical significance (3). The age distribution of the patients in the present study is normal for myeloma populations.…”

Section: Discussionsupporting

confidence: 49%

Staging and survival in multiple myeloma

Wåhlin

1984

Scandinavian Journal of Haematology

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The records of 91 patients with multiple myeloma were reviewed and staging was performed according to Durie & Salmon (1). Patients with progressive disease were re‐staged. Patients first diagnosed in stage I were younger than patients first diagnosed in stage III and survived longer than patients in stages II or III. The duration of stage I was longer than the duration of stages II and III. When patients in stage I‐II progressed into stage III, their age and remaining survival time were similar to the age and survival of patients first diagnosed in stage III. These findings are compatible with the hypothesis that myeloma stage I prededes myeloma stage III and is often diagnosed by chance. It is suggested that patients with myeloma stage I should be omitted from comparisons between different myeloma populations.

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“…Clinical staging according to Durie & Salmon ( 3 ) is the most widely used classification to describe different risk groups. However, the ability of this and other staging systems to predict prognosis is not universally confirmed (19,20) and identification of other prognostic factors seems to be important. In the present material, multivariate analysis showed that survival was affected by clinical stage but to a lesser extent than by blood CBE or response to initial therapy ( Table 3).…”

Section: Discussionmentioning

confidence: 99%

Blood clonal B cell excess at diagnosis in multiple myeloma: Relation to prognosis

Österborg

Nilsson²,

Björkholm

et al. 1987

European J of Haematology

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112 patients with multiple myeloma have been studied at diagnosis for the presence of blood clonal B‐cell excess (CBE), defined as a ratio between k+ and λ+ lymphocytes outside the normal range (0.9‐3.5). 48 patients (43%) had CBE. The increase in light chain‐bearing lymphocytes was always that of the M component light chain isotype. The proportions of patients exhibiting CBE were the same in different stages. The response frequency was not influenced by the presence of CBE. However, patients with CBE had a shorter remission duration time (p < 0.001) and total survival (p < 0.05) than those without CBE. This was also noticed when each clinical stage was analyzed separately. Moreover, survival was shorter in patients with a large fraction of CBE than in those with a small one. Cox regression analysis revealed that CBE was a much stronger predictor of remission duration than age, clinical stage and renal dysfunction. CBE and response to initial treatment independently were the best factors to indicate survival. It is suggested that analysis of CBE should be included in the clinical characterization of untreated patients with multiple myeloma.

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Critical Study of Staging in Multiple Myeloma

Cited by 23 publications

References 19 publications

Improvement of Durie & Salmon staging for multiple myeloma by adding platelet count as a stratifying variable: A multivariate regression analysis of 163 untreated patients

Improvement of Durie & Salmon staging for multiple myeloma by adding platelet count as a stratifying variable: A multivariate regression analysis of 163 untreated patients

Staging and survival in multiple myeloma

Blood clonal B cell excess at diagnosis in multiple myeloma: Relation to prognosis

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