Proliferative activity of plasma cells is the most relevant prognostic factor in elderly multiple myeloma patients

International Journal of Cancer. Journal International Du Cancer
R García-SanzJ F San Miguel

Abstract

Although multiple myeloma (MM) is predominantly a disease of the elderly, few studies have focused on the identification of prognostic factors in this group of patients. Four hundred twenty five MM patients >65 years were uniformly treated with chemotherapy (MP or VCMP/VBAD). Multivariate analysis identified 4 factors with independent unfavorable prognostic influence: high percentage of S-phase bone marrow plasma cells (>2.5%); elevated beta(2) microglobulin (B2M) (>4 mg/L); age >80 years old; and LDH serum levels (above normal limit). The S-phase value was the most powerful independent prognostic factor to discriminate subgroups of patients with different prognosis. Thus, 3 main risk categories could be identified according to S-phase values: </=1%, 1-3% and >3%, with median survivals of 34, 22 and 12 months, respectively (p < 0.0001). Our study also proved the value for elderly patients of the recently developed International Score System (ISS) based on B2M and albumin. Furthermore, the number of S-phase cells helped to subdivide the ISS III Group identifying a subset of patients with very poor prognosis defined by an additional high S-phase, who displayed a median survival of only 8 months. These results demonstrate that eld...Continue Reading

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Citations

Dec 17, 2009·The Cancer Journal·Jesus San-MiguelNorma C Gutierrez
Jul 20, 2007·Blood·David GonzálezGareth J Morgan
Feb 13, 2016·Cytometry. Part a : the Journal of the International Society for Analytical Cytology·Constance M Yuan
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Aug 19, 2007·European Journal of Haematology·Thomas GastinneUNKNOWN Intergroupe Francophone du Myelome (IFM)
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Jun 10, 2006·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Jesús F San MiguelAlberto Orfao
Jul 20, 2005·Best Practice & Research. Clinical Haematology·Jesús F San Miguel, Ramón García-Sanz
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