The Applicability of the International Staging System in Chinese Patients with Multiple Myeloma Receiving Bortezomib or Thalidomide-Based Regimens as Induction Therapy: A Multicenter Analysis

Abstract

The International Staging System (ISS) is the most important prognostic system for multiple myeloma (MM). It was identified in the era of conventional agents. The outcome of MM has significantly changed by novel agents. Thus the applicability of ISS system in the era of novel agents in Chinese patients needs to be demonstrated. We retrospectively analyzed the clinical outcomes and prognostic significance of ISS system in 1016 patients with newly diagnosed multiple myeloma in Chinese patients between 2008 and 2012, who received bortezomib- or thalidomide-based regimens as first-line therapy. The median overall survival (OS) of patients for ISS stages I/II/III was not reached/55.4 months/41.7 months (p < 0.001), and the median progression-free survival (PFS) was 30/29.5/25 months (p = 0.072), respectively. Statistically significant difference in survival was confirmed among three ISS stages in thalidomide-based group, but not between ISS stages I and II in bortezomib-based group. These findings suggest that ISS system can predict the survival in the era of novel agents in Chinese MM patients, and bortezomib may have the potential to partially overcome adverse effect of risk factors on survival, especially in higher stage of ISS system.

Neuropatia periférica em pessoas com mieloma múltiplo

“…(15) Findings regarding marital status, employment status, level of education, and comorbidities are also in line with previous studies. (2,11,18) In this study, 40% of individuals had been treated for SAH; a study carried out in the United States with 2,587 patients with advanced MM which aimed to analyze the risks of adverse effects associated with treatments of MM in elderly people found that patients with SAH, PN, thromboembolic events, and heart diseases had a significantly higher risk of developing some toxicity in 6 to 12 months after the beginning of treatment.. (19) These data are worrying and confirm the results of this work, since the prevalence of PN before the begin-ning of treatment (20%) and the incidence during and after treatment nearly tripled.…”

“…The same finding was pointed out in a cohort study with Chinese patients, in which most of them were undergoing che-motherapy and were at stage II and III, according to the ISS system; a statistically significant association between staging and prognosis, which are inversely proportional, was also observed. (11) It should be added that when PN results from antineoplastic chemotherapy, it is called chemotherapy-induced peripheral neuropathy (CIPN).…”

“…(1,(6)(7)(8) It is worth highlighting that chemotherapy regimens to treat this disease are prescribed according to a staging system and more than half of them include bortezomib. (1,(9)(10)(11) Peripheral neuropathy appears with sensory symptoms such as burning dysesthesia, paresthesia, hyperesthesia, and pain. Despite being less common, motor alterations may also occur.…”

“…Despite being less common, motor alterations may also occur. (11) It can be scaled according to the sensory and motor neuropathy changes. In the first degree, patients are asymptomatic or lose deep reflexes or present paresthesia, which does not affect the function and, in motor neuropathy, it is asymptomatic; keeping the drug dosage is recommended.…”

Evolution of Anti-Cancer Treatment and its Impact on Surrogate Prognostic Factors in Multiple Myeloma

“…На достоверности прогноза сказывается отсутствие международной стандартизации норм лабораторных показателей, которые входят в различные прогностические системы ММ. В результате прогностическое значение отдельных систем может различаться, например, в разных странах [8,9]. Научные работы по этой тематике в последние годы представлены лишь единичными публикациями [10].…”