Risk Assessment For Multiple Myeloma: Preliminary Results Of The Brazilian Myeloma Study Group

The Durie/Salmon staging system continues to be used worldwide in patients with multiple myeloma. However, in recent years, new systems have been proposed. The International Myeloma Working Group performed a retrospective study with 11,179 patients and proposed an "International Staging System" utilizing serum levels of â2 microglobulin and albumin. In addition, current research has focused on the usefulness of cytogenetic and molecular data as prognostic factors. These data suggest that these parameters are powerful discriminators of a poor prognostic group of myeloma patients. Indeed, these prognostic indexes have been utilized in clinical trials, with interesting and encouraging results.30SUPPL. 269Alexanian, R., Haut, A., Khan, A.U., Treatment for multiple myeloma. Combination chemotherapy with different melphalan dose regimens (1969) JAMA, 208 (9), pp. 1680-1685Alexanian, R., Barlogie, B., Tucker, S., VAD-based regimens as primary treatment for multiple myeloma (1990) Am J Hematol, 33 (2), pp. 86-89Pasqualetti P, Collacciani A, Colantonio D, Casale R. [Multiple myeloma: epidemiologic and clinical considerations]. G Ital Oncol. 1990;10(3):71-6Smith, A., Wisloff, F., Samson, D., Guidelines on the diagnosis and management of multiple myeloma 2005 (2006) Br J Haematol, 132 (4), pp. 410-451Paule, B., Prognostic factors of multiple myeloma] (1997) Ann Med Interne (Paris), 148 (8), pp. 534-541San Miguel, J.F., Sanchez, J., Gonzalez, M., Prognostic factors and classification in multiple myeloma (1989) Br J Cancer, 59 (1), pp. 113-118Durie, B.G., Bataille, R., Therapeutic implications of myeloma staging (1989) Eur J Haematol Suppl, 51, pp. 111-116Durie, B.G., Kyle, R.A., Belch, A., Myeloma management guidelines: A consensus report from the Scientific Advisors of the International Myeloma Foundation (2003) Hematol J, 4 (6), pp. 379-398Garban, F., Attal, M., Michallet, M., Prospective comparison of autologous stem cell transplantation followed by a dose-reduced allograft (IFM99-03 trial) with tandem autologous stem cell transplantation (IFM99-04 trial) in high-risk de novo multiple myeloma (2006) Blood, 107 (1), pp. 397-403Greipp, P.R., San, M.J., Durie, B.G., International staging system for multiple myeloma (2005) J Clin Oncol, 23 (15), pp. 3412-3420Bataille, R., Durie, B.G., Grenier, J., Sany, J., Prognostic factors and staging in multiple myeloma: A reappraisal (1986) J Clin Oncol, 4 (1), pp. 80-87Durie, B.G., Salmon, S.E., A clinical staging system for multiple myeloma. Correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival (1975) Cancer, 36 (3), pp. 842-854Bataille, R., Grenier, J., Sany, J., Beta-2-microglobulin in myeloma: Optimal use for staging, prognosis, and treatment - a prospective study of 160 patients (1984) Blood, 63 (2), pp. 468-476Hungria, V., Maiolino, A., Martinez, G., Validation of the International Staging System (ISS) for multiple myeloma: A retrospective analysis of 487 patients at 8 Brazilian centers (2008) Haematologica, 93 (5), pp. 791-792Bataille, R., Boccadoro, M., Klein, B., Durie, B., Pileri, A., C-reactive protein and beta-2 microglobulin produce a simple and powerful myeloma staging system (1992) Blood, 80 (3), pp. 733-737Terpstra, W.E., Lokhorst, H.M., Blomjous, F., Meuwissen, O.J., Dekker, A.W., Comparison of plasma cell infiltration in bone marrow biopsies and aspirates in patients with multiple myeloma (1992) Br J Haematol, 82 (1), pp. 46-49Rawstron, A., Barrans, S., Blythe, D., Distribution of myeloma plasma cells in peripheral blood and bone marrow correlates with CD56 expression (1999) Br J Haematol, 104 (1), pp. 138-143Rawstron, A.C., Owen, R.G., Davies, F.E., Circulating plasma cells in multiple myeloma: Characterization and correlation with disease stage (1997) Br J Haematol, 97 (1), pp. 46-55Ribas, C., Colleoni, G.W., Silva, M.R., Carregoza, M.J., Bordin, J.O., Prognostic significance of vascular endothelial growth factor immunoexpression in the context of adverse standard prognostic factors in multiple myeloma (2004) Eur J Haematol, 73 (5), pp. 311-317Ribas, C., Colleoni, G.W., Felix, R.S., p16 gene methylation lacks correlation with angiogenesis and prognosis in multiple myeloma (2005) Cancer Lett, 222 (2), pp. 247-254Tricot, G., Barlogie, B., Jagannath, S., Poor prognosis in multiple myeloma is associated only with partial or complete deletions of chromosome 13 or abnormalities involving 11q and not with other karyotype abnormalities (1995) Blood, 86 (11), pp. 4250-4256Flactif, M., Zandecki, M., Lai, J.L., Interphase fluorescence in situ hybridization (FISH) as a powerful tool for the detection of aneuploidy in multiple myeloma (1995) Leukemia, 9 (12), pp. 2109-2114Facon, T., vet-Loiseau, H., Guillerm, G., Chromosome 13 abnormalities identified by FISH analysis and serum beta2-microglobulin produce a powerful myeloma staging system for patients receiving high-dose therapy (2001) Blood, 97 (6), pp. 1566-1571Braggio, E., Magalhaes, R., Maiolino, A., Zalcberg, I., Study of cromosomal abnormalities with prognostic impact in pacients with multiple myeloma (2005) Revista Brasileira de Hematologia e Hemoterapia, 27 (4), pp. 162-163Moreau, P., Hullin, C., Garban, F., Tandem autologous stem cell transplantation in high-risk de novo multiple myeloma: Final results of the prospective and randomized IFM 99-04 protocol (2006) Blood, 107 (1), pp. 397-403Loiseau H, Attal M, Moreau P et al. A comprehensive analysis of citogenetic abnormalities in Myeloma: results of the FISH analysis of 1000 patients enrolled in IFM99 trials. Blood (ASH Meeting Abstracts) 106, Abstract 622. 2005Maiolino, A., Magalhaes, R., Nucci, M., Fase III, multicenter, prospective trial to treatment of early diagnosed multiple myeloma. Aprouch based on risk. Preliminary results (2005) Rev. bras. hematol. hemoter, 27 (4), p. 163Attal, M., Harrousseau, J., Leyvraz, S., Maintanance therapy with thalidmide improves survival in patients with multiple myeloma (2006) Blood, 108 (10), pp. 3289-3294Barlogie Jr., B., Shaughnessy, J.D., Early results of total therapy II in multiple myeloma: Implications of cytogenetics and FISH (2002) Int J Hematol, 76 (SUPPL. 1), pp. 337-339Riccardi, A., Ucci, G., Luoni, R., Treatment of multiple myeloma according to the extension of the disease: A prospective, randomised study comparing a less with a more aggressive cystostatic policy. Cooperative Group of Study and Treatment of Multiple Myeloma (1994) Br J Cancer, 70 (6), pp. 1203-121