What is meant by the term high-risk myeloma?

Clinical Pearls Podcasts published on April 10, 2017
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Joshua Richter, MD
Assistant Professor of Medicine
Icahn School of Medicine at Mount Sinai
New York, New York
What is meant by the term high-risk myeloma?
  1. Risk stratification in myeloma
    1. Evaluation of biological, laboratory and cytogenetic factors to determine the patient’s potential to achieve a positive outcome, in terms of overall and progression-free survival
    2. Does not necessarily reflect how an individual patient will respond to therapy
  2. Tools for risk stratification
    1. mSMART.org by the Mayo Clinic includes factors such as early relapse following induction therapy
    2. R-ISS, the Revised International Staging System, also incorporates high-risk cytogenetic factors; higher R-ISS stages have reduced survival
      1. Five-year overall survival rate for R-ISS I is 82%, compared to 40% for R-ISS III
      2. Five-year progression-free survival rate for R-ISS I is 55%, compared to 24% for R-ISS III
  3. High-risk myeloma refers to certain abnormalities (including genetic factors such as 17p deletion) and high-risk gene expression profiles that will predispose patients with these factors to shorter remissions and earlier relapse
Last modified: April 10, 2017
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