Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis
Abstract The Mayo-2018 smoldering multiple myeloma (SMM) risk score is used routinely in the clinical setting but has only been validated at diagnosis. In SMM patients, the progression risk decreases over time. However, the utility of applying risk stratification models after diagnosis is unknown. W...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2021-11-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-021-00569-2 |
| _version_ | 1818752643056533504 |
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| author | Alissa Visram S. Vincent Rajkumar Prashant Kapoor Angela Dispenzieri Martha Q. Lacy Morie A. Gertz Francis K. Buadi Suzanne R. Hayman David Dingli Taxiarchis Kourelis Wilson Gonsalves Rahma Warsame Eli Muchtar Nelson Leung Linda B. Baughn Robert A. Kyle Shaji Kumar |
| author_facet | Alissa Visram S. Vincent Rajkumar Prashant Kapoor Angela Dispenzieri Martha Q. Lacy Morie A. Gertz Francis K. Buadi Suzanne R. Hayman David Dingli Taxiarchis Kourelis Wilson Gonsalves Rahma Warsame Eli Muchtar Nelson Leung Linda B. Baughn Robert A. Kyle Shaji Kumar |
| author_sort | Alissa Visram |
| collection | DOAJ |
| description | Abstract The Mayo-2018 smoldering multiple myeloma (SMM) risk score is used routinely in the clinical setting but has only been validated at diagnosis. In SMM patients, the progression risk decreases over time. However, the utility of applying risk stratification models after diagnosis is unknown. We retrospectively studied 704 SMM patients and applied the Mayo 2018 and IMWG-2020 risk stratification models at annual landmark timepoints up to 5 years post diagnosis. The Mayo-2018 and IMWG-2020 models reliably stratified patients based on progression risk when applied post diagnosis. The respective 2-year progression risk in Mayo-2018 high risk patients versus IMWG-2020 intermediate-high risk patients was 51% versus 62% at the 1-year landmark and 47% versus 45% at the 4-year landmark. We showed that patients categorized at Mayo-2018 high-risk at follow-up had a similar risk of progression if the baseline risk assessment was low-intermediate versus high-risk (HR 1.04, 95% CI 0.46–2.36, p = 0.931 at 5-year landmark). Patients migrating to a higher risk category during follow up had a higher progression risk compared to patients with stable/decreased risk categorization. Our findings support the use of these risk scores post-diagnosis and suggest that patients evolving to a high-risk category may benefit from early intervention therapeutic approaches. |
| first_indexed | 2024-12-18T04:54:43Z |
| format | Article |
| id | doaj.art-93d4ece315db4f62bf0683715cca31d3 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-12-18T04:54:43Z |
| publishDate | 2021-11-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-93d4ece315db4f62bf0683715cca31d32022-12-21T21:20:20ZengNature Publishing GroupBlood Cancer Journal2044-53852021-11-0111111810.1038/s41408-021-00569-2Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosisAlissa Visram0S. Vincent Rajkumar1Prashant Kapoor2Angela Dispenzieri3Martha Q. Lacy4Morie A. Gertz5Francis K. Buadi6Suzanne R. Hayman7David Dingli8Taxiarchis Kourelis9Wilson Gonsalves10Rahma Warsame11Eli Muchtar12Nelson Leung13Linda B. Baughn14Robert A. Kyle15Shaji Kumar16Division of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Nephrology, Mayo Clinic RochesterDivision of Laboratory Genetics and Genomics, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterDivision of Hematology, Mayo Clinic RochesterAbstract The Mayo-2018 smoldering multiple myeloma (SMM) risk score is used routinely in the clinical setting but has only been validated at diagnosis. In SMM patients, the progression risk decreases over time. However, the utility of applying risk stratification models after diagnosis is unknown. We retrospectively studied 704 SMM patients and applied the Mayo 2018 and IMWG-2020 risk stratification models at annual landmark timepoints up to 5 years post diagnosis. The Mayo-2018 and IMWG-2020 models reliably stratified patients based on progression risk when applied post diagnosis. The respective 2-year progression risk in Mayo-2018 high risk patients versus IMWG-2020 intermediate-high risk patients was 51% versus 62% at the 1-year landmark and 47% versus 45% at the 4-year landmark. We showed that patients categorized at Mayo-2018 high-risk at follow-up had a similar risk of progression if the baseline risk assessment was low-intermediate versus high-risk (HR 1.04, 95% CI 0.46–2.36, p = 0.931 at 5-year landmark). Patients migrating to a higher risk category during follow up had a higher progression risk compared to patients with stable/decreased risk categorization. Our findings support the use of these risk scores post-diagnosis and suggest that patients evolving to a high-risk category may benefit from early intervention therapeutic approaches.https://doi.org/10.1038/s41408-021-00569-2 |
| spellingShingle | Alissa Visram S. Vincent Rajkumar Prashant Kapoor Angela Dispenzieri Martha Q. Lacy Morie A. Gertz Francis K. Buadi Suzanne R. Hayman David Dingli Taxiarchis Kourelis Wilson Gonsalves Rahma Warsame Eli Muchtar Nelson Leung Linda B. Baughn Robert A. Kyle Shaji Kumar Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis Blood Cancer Journal |
| title | Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis |
| title_full | Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis |
| title_fullStr | Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis |
| title_full_unstemmed | Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis |
| title_short | Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis |
| title_sort | assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis |
| url | https://doi.org/10.1038/s41408-021-00569-2 |
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