Improved Outcomes Among Newly Diagnosed Patients with FLT3‐ITD Mutated AML Treated with Contemporary Therapy: Revisiting the ELN Adverse Risk Classification

2022 ◽  
Author(s):  
Patrick K. Reville ◽  
Koji Sasaki ◽  
Hagop M. Kantarjian ◽  
Naval G. Daver ◽  
Musa Yilmaz ◽  
...  
Keyword(s):  
Risk Classification ◽  
Newly Diagnosed ◽  
Improved Outcomes

Clinical significance of translocation t(1;19) in childhood acute lymphoblastic leukemia in the context of contemporary therapies: a report from the Children's Cancer Group.

1998 ◽  
Vol 16 (2) ◽  
pp. 527-535 ◽  
Author(s):  
F M Uckun ◽  
M G Sensel ◽  
H N Sather ◽  
P S Gaynon ◽  
D C Arthur ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Lymphoblastic Leukemia ◽  
Prognostic Significance ◽  
Newly Diagnosed ◽  
Event Free Survival ◽  
Free Survival ◽  
Cancer Group ◽  
Improved Outcomes ◽  
B Lineage ◽  
The Individual

PURPOSE The nonrandom translocation t(1;19) has been associated with poor outcome in pediatric B-lineage acute lymphoblastic leukemia (ALL). Because most patients treated by contemporary therapies now achieve improved outcomes, we have reassessed the prognostic significance of t(1;19). PATIENTS AND METHODS Cytogenetic data were accepted for 1,322 children (<21 years old) with newly diagnosed ALL enrolled between 1988 and 1994 on risk-adjusted studies of the Children's Cancer Group (CCG). Forty-seven patients (3.6%) were t(1;19) positive (+); 1,275 (96.4%) were t(1;19) negative (-). Clinical characteristics and treatment outcome were compared using standard methods. RESULTS Translocation (1;19)+ patients were more likely than t(1;19)- patients to be 10 years of age or greater (P < .001) or CD10+ CD19+ CD34- (P < .0001), or nonwhite (P = .02). Patients with a balanced t(1;19) were less likely to be hyperdiploid than patients with an unbalanced der(19)t(1;19). Event-free survival (EFS) was similar for the overall group of t(1;19)+ and t(1;19)- patients, with 4-year estimates of 69.5% (SD, 6.8%) and 74.8% (SD, 1.3%; P = .48), respectively. However, patients with unbalanced der(19)t(1;19) had significantly better outcomes than patients with balanced t(1;19): 4-year EFS were 80.6% (SD, 7.1%) and 41.7% (SD, 13.5%), respectively (P = .003). These differences were maintained within the individual studies analyses and after exclusion of t(1;19)+ patients whose cells were hyperdiploid with more than 50 chromosomes. CONCLUSION The overall group of t(1;19)+ patients, as well as the subgroup with an unbalanced der(19)+ (1;19) had outcomes similar to that of t(1;19)- patients, whereas patients with balanced t(1;19) had poorer outcomes. Thus, although the overall prognostic significance of t(1;19) has been obviated by contemporary risk-adjusted protocols, the balanced t(1;19) translocation remains an adverse prognostic factor.

scholarly journals Improved Outcomes with Induction Chemotherapy Combined with Arsenic Trioxide in Stage 4 Neuroblastoma: A Case Series

2021 ◽  
Vol 20 ◽  
pp. 153303382110414
Author(s):  
Yang Li ◽  
Chuchu Feng ◽  
Yantao Chen ◽  
Ke Huang ◽  
Chunmou Li ◽  
...  
Keyword(s):  
Arsenic Trioxide ◽  
Induction Chemotherapy ◽  
Case Series ◽  
Symptomatic Treatment ◽  
Newly Diagnosed ◽  
Chemotherapy Drugs ◽  
Improved Outcomes ◽  
Stage 4 ◽  
Alternative Means ◽  
Potential Alternative

Objective: The apoptotic and cytotoxic effects of arsenic trioxide (ATO) makes it a potentially suitable agent for the treatment of patients with neuroblastoma with poor prognosis; therefore, we try to evaluate the effectiveness and safety of ATO combined with reinduction/induction chemotherapy in children with recurrent/refractory or newly diagnosed stage 4 neuroblastoma. Methods: Retrospective analysis was performed on seven pediatric patients with recurrent /refractory or newly diagnosed stage 4 neuroblastoma treated with traditional reinduction/induction chemotherapy combined with ATO. Results: A total of 7 patients were treated synchronously with ATO and chemotherapy for up to nine courses; all patients received conventional chemotherapy plus a 0.16 mg/kg/day dose of intravenous ATO during reinduction/induction chemotherapy. Treatment was effective in five patients and ineffective in the other two patients. The overall response rate was 71.43% (5 of 7). The side effects of the ATO combination were minor, whereby only treatment in one patient was terminated at the sixth course due to a prolonged QT interval (0.51 s), which returned to normal after symptomatic treatment. Conclusions: ATO can be safely and effectively combined with chemotherapy drugs as a potential alternative means of treatment for high-risk stage 4 neuroblastoma, and we have observed that ATO can restore the sensitivity of chemotherapy in some patients who were resistant to previous chemotherapy. Further investigations and clinical data are required to confirm these observations.

Outcomes with CPX-351 versus 7+3 by baseline bone marrow (BM) blast percentage in older adults with newly diagnosed high-risk/secondary acute myeloid leukemia (sAML).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 7042-7042
Author(s):  
Ellen K. Ritchie ◽  
Tara L. Lin ◽  
Laura F. Newell ◽  
Robert K. Stuart ◽  
Scott R. Solomon ◽  
...  
Keyword(s):  
Older Adults ◽  
High Risk ◽  
Newly Diagnosed ◽  
Phase 3 ◽  
Secondary Acute Myeloid Leukemia ◽  
Improved Outcomes ◽  
The Us ◽  
Remission Rates ◽  
Grade 3 ◽  
Post Hoc

7042 Background: CPX-351, a liposomal encapsulation of cytarabine (C) and daunorubicin (D) at a synergistic ratio, is approved as Vyxeos in the US and EU for adults with newly diagnosed therapy-related AML or AML with myelodysplasia-related changes. In a phase 3 study, CPX-351 significantly improved OS and remission rates vs 7+3 in patients (pts) aged 60-75 y with newly diagnosed high-risk/sAML. Some studies suggest a high baseline blast percentage may portend a worse prognosis in AML. This post hoc analysis of phase 3 data assessed outcomes by baseline BM blast percentage. Methods: Pts diagnosed with AML per 2008 WHO criteria (≥20% blasts in peripheral blood or BM) were randomized 1:1 to receive ≤2 inductions of CPX-351 (100 units/m2 [C 100 mg/m2 + D 44 mg/m2] on Days 1, 3, 5 [2nd induction: Days 1, 3]) or 7+3 (C 100 mg/m2/d continuously for 7 d [2nd induction: 5 d] + D 60 mg/m2 on Days 1-3 [2nd induction: Days 1-2]). Pts achieving complete remission (CR) or CR with incomplete platelet or neutrophil recovery (CRi) could receive ≤2 consolidations. Results: CPX-351 had longer median OS and higher remission rates vs 7+3 irrespective of baseline BM blast percentage; median OS was worse in higher blast groups for both treatments (Table). The incidence of grade ≥3 TEAEs was >80% for both arms; febrile neutropenia was the most common. Conclusions: Improved outcomes were observed with CPX-351 vs 7+3 irrespective of baseline BM blast percentage in older adults with newly diagnosed high-risk/sAML. Clinical trial information: NCT01696084. [Table: see text]

Validation of Alternative Chronic Myelomonocytic Leukemia (CMML)-Specific Prognostic Scoring (CPSS) System in UT MD Anderson Cancer Center Cohort

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3278-3278
Author(s):  
Priyanka Priyanka ◽  
Janhavi Raut ◽  
Patricia S Fox ◽  
Francesco Stingo ◽  
Tariq Muzzafar
Keyword(s):  
Overall Survival ◽  
Scoring System ◽  
Risk Groups ◽  
Risk Classification ◽  
Chronic Myelomonocytic Leukemia ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Md Anderson ◽  
Myelomonocytic Leukemia

Abstract INTRODUCTION: Chronic myelomonocytic leukemia (CMML) is a myeloid neoplasm that belongs to the category of myelodysplastic syndrome / myeloproliferative neoplasms (MDS / MPN). The International Prognostic Scoring System for Myelodysplastic Syndromes (IPSS) classification and its revised version (IPSS-R) addressed patients with newly diagnosed, untreated MDS and excluded CMML. While numerous investigators have attempted to devise a prognostic risk scoring system for CMML, no system has been generally accepted for this entity. A CMML-specific prognostic scoring (CPSS) system proposed by Such, et al [Blood. 2013; 11;121(15):3005-15] defines 4 different prognostic risk categories for estimating both overall survival (OS) and risk for AML transformation; the alternative version replaces RBC transfusion dependency with hemoglobin levels. AIM: The aim of the study is to validate the alternative CPSS scoring system on the CMML patient cohort at UT MD Anderson Cancer Center (UTMDACC). METHODS: The databases of the Department of Hematopathology at UTMDACC were searched for patients diagnosed with CMML presenting from 2005 to 2012. Cases were classified by WHO 2008 criteria. Inclusion criteria were: confirmed diagnosis of CMML, age > 18 years, persistent absolute monocyte count >1 × 109/L, marrow blasts < 20%, peripheral blood blasts < 20%. The alternative CPSS score was calculated as a function of WHO subtype, FAB subtype, CMML-specific cytogenetic risk classification, and hemoglobin score. Cox proportional hazards regression was used to model overall survival and time to AML progression from date of diagnosis. For time to AML progression, patients who did not experience AML progression were censored at their date of death or last follow-up. Kaplan-Meier curves were used to estimate survival and the log-rank test was used to test for significant differences by CPSS score. All statistical analyses were performed using SAS 9.3 for Windows. RESULTS: Two hundred and three patients with newly diagnosed, untreated CMML were identified in the clinical databases. These included 132 males and 71 females; median age was 70 (range 55-80) years. 149 had CMML-1 and 54 had CMML-2. A total of 107 deaths and 38 progressions were observed. The median (range) follow-up time for all patients was 1.9 (2 days-10.8) years. The variables that compose the alternative CPSS (WHO subtype, FAB subtype, CMML-specific cytogenetic risk classification, hemoglobin) as well as a description of how the score is calculated are given in Tables 1-2. In univariate Cox models, the alternative CPSS score was a significant predictor of both OS and time to AML progression (Type III p-values <.0001 and 0.0037, respectively). Median survival times for OS were 4.07, 3.32, 2.14, and 1.23 years in the low, intermediate-1, intermediate-2, and high risk groups, respectively. Since less than half the patients progressed, the median time to AML progression could not be estimated for all groups but was 6.40 and 1.60 in the intermediate-2 and high risk groups, respectively. Overall, the alternative CPSS score was highly predictive of both OS and progression free survival (PFS) and clearly delineated the patient risk groups in this sample. CONCLUSIONS: These data reinforce the validity of the alternative CPSS and serve as an additional validation cohort. Table 1. Alternative CMML-specific prognostic scoring system (CPSS) score criteria Variable Each level assigned the following value(sum to get the composite CPSS score): 0 1 2 WHO subtype CMML-1 blasts (including promonocytes) <5% in the PB and <10% in the BM CMML-2 blasts (including promonocytes) from 5% to 19% in the PB and from 10% to 19% in the BM, or when Auer rods are present irrespective of blast count — FAB subtype CMML-MD (WBC <13 × 109/L) CMML-MP (WBC ≥13 × 109/L) — CMML-specific cytogenetic risk classification* Low Intermediate High Hemoglobin ≥10 g/dL <10/dL WBC: white blood cell * CMML-specific cytogenetic risk classification; low: normal and isolated –Y; intermediate: other abnormalities; and high: trisomy 8, complex karyotype (≥3 abnormalities), chromosome 7 abnormalities Table 2. Alternative CPSS: scores used for predicting likelihood of survival and leukemic evolution in individual patient with CMML Risk group Overall CPSS score Low 0 Intermediate-1 1 Intermediate-2 2-3 High 4-5 Figure 1 Overall Survival by alternative CPSS Score Figure 1. Overall Survival by alternative CPSS Score Figure 2 Time to AML Progression by alternative CPSS Score Figure 2. Time to AML Progression by alternative CPSS Score Disclosures No relevant conflicts of interest to declare.

Overall survival (OS) with CPX-351 versus 7+3 in older adults with newly diagnosed, therapy-related acute myeloid leukemia (tAML): Subgroup analysis of a phase III study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 7035-7035 ◽  
Author(s):  
Jeffrey E. Lancet ◽  
David Rizzieri ◽  
Gary J. Schiller ◽  
Robert K. Stuart ◽  
Jonathan E. Kolitz ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Therapeutic Option ◽  
Late Complication ◽  
Phase Iii ◽  
Molar Ratio ◽  
Newly Diagnosed ◽  
Open Label ◽  
Improved Outcomes ◽  
Phase Iii Study ◽  
Anthracycline Chemotherapy

7035 Background: tAML may occur as a late complication of cytotoxic therapy and is associated with a poor prognosis. CPX-351 is a liposomal formulation that delivers a synergistic 5:1 molar ratio of cytarabine (C) and daunorubicin (D). In a randomized, open-label, controlled phase III trial in patients (pts) aged 60-75 years with newly diagnosed, secondary AML (tAML or after MDS), CPX-351 significantly improved OS versus 7+3. The current analysis of this phase III study evaluated outcomes in the subgroup of pts with tAML. Methods: Pts were randomized 1:1 to induction with 1-2 cycles of CPX-351 (100 u/m2 [C 100 mg/m2 + D 44 mg/m2] on Days 1, 3, and 5 [2nd induction: Days 1 and 3]) or 7+3 (C 100 mg/m2/day x 7 days [2nd induction: x 5 days] + D 60 mg/m2on Days 1, 2, and 3 [2nd induction: Days 1 and 2]). Pts with complete remission (CR) or CR with incomplete platelet or neutrophil recovery (CRi) could receive up to 2 cycles of consolidation therapy. The study was not powered for this subgroup analysis. Results: 304 pts were enrolled and received study treatment, including 62 (20%) pts with tAML; demographics of tAML pts were similar between study arms. Pts with tAML had typically received prior non-anthracycline chemotherapy alone (25%), radiation alone (25%), or non-anthracycline chemotherapy + radiation (32%). CPX-351 was associated with an OS benefit versus 7+3 in older tAML pts and numerically longer event-free survival (EFS) and remission duration (Table). A greater proportion of tAML pts achieved CR+CRi (47% vs 36%, respectively) and proceeded to stem cell transplantation (37% vs 27%) with CPX-351. The safety profile of CPX-351 was comparable to that of 7+3. Conclusions: CPX-351 is associated with improved outcomes in older pts with newly diagnosed tAML. Outcomes in the tAML subgroup mirrored the overall study population, indicating CPX-351 may represent a new therapeutic option for this difficult to treat population. Clinical trial information: NCT01696084. [Table: see text]

scholarly journals Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN)

Blood ◽  
2011 ◽  
Vol 118 (17) ◽  
pp. 4519-4529 ◽  
Author(s):  
Antonio Palumbo ◽  
Sara Bringhen ◽  
Heinz Ludwig ◽  
Meletios A. Dimopoulos ◽  
Joan Bladé ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Elderly Patients ◽  
Standard Treatment ◽  
Autologous Transplantation ◽  
Treatment Strategies ◽  
Dose Intensity ◽  
Newly Diagnosed ◽  
Improved Outcomes ◽  
Drug Doses ◽  
Vulnerable Elderly

Abstract Most patients with newly diagnosed multiple myeloma (MM) are aged > 65 years with 30% aged > 75 years. Many elderly patients are also vulnerable because of comorbidities that complicate the management of MM. The prevalence of MM is expected to rise over time because of an aging population. Most elderly patients with MM are ineligible for autologous transplantation, and the standard treatment has, until recently, been melphalan plus prednisone. The introduction of novel agents, such as thalidomide, bortezomib, and lenalidomide, has improved outcomes; however, elderly patients with MM are more susceptible to side effects and are often unable to tolerate full drug doses. For these patients, lower-dose-intensity regimens improve the safety profile and thus optimize treatment outcome. Further research into the best treatment strategies for vulnerable elderly patients is urgently needed. Appropriate screening for vulnerability and an assessment of cardiac, pulmonary, renal, hepatic, and neurologic functions, as well as age > 75 years, at the start of therapy allows treatment strategies to be individualized and drug doses to be tailored to improve tolerability and optimize efficacy. Similarly, occurrence of serious nonhematologic adverse events during treatment should be carefully taken into account to adjust doses and optimize outcomes.

Outcomes of Patients with Newly-Diagnosed Acute Myeloid Leukemia Over the Last 5 Decades At M.D. Anderson Cancer Center

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 2606-2606
Author(s):  
Alfonso Quintás-Cardama ◽  
Hagop Kantarjian ◽  
Farhad Ravandi ◽  
Guillermo Garcia-Manero ◽  
Stefan Faderl ◽  
...  
Keyword(s):  
Median Overall Survival ◽  
Conflicts Of Interest ◽  
Complete Response ◽  
Early Mortality ◽  
Cancer Center ◽  
Newly Diagnosed ◽  
Improved Outcomes ◽  
Response To Chemotherapy ◽  
Binding Factor ◽  
Higher Doses

Abstract Abstract 2606 Background: For the last 40 years, cytosine arabinoside (ara-C) combined with anthracycline (at different dose schedules) has been considered standard therapy for AML. Multiple novel agents have been added to that combination in an attempt to improve AML outcomes. We evaluated the survival of patients with AML treated at our institution over the last 5 decades. Methodology: A total of 3,631 patients with newly-diagnosed non-APL AML, 294 CBF-AML, and 237 APL registered in the MDACC Leukemia Database (1965–2010) were evaluated. Patients were divided by decade of referral. Outcomes in specific AML subtypes were evaluated in patients enrolled in 80 different chemotherapeutic protocols used since 1985 when cytogenetic information was consistently available. Analyses comparing different regimens included only protocols that accrued a minimum of 30 patients. Results: Median overall survival (OS) per decade (1960 to 2010) was 2.1, 8.5, 8.5, 10.4, and 12.5 mos. 1-yr OS was 26%, 41%, 41%, 45%, 51% (Fig 1A). While the prognosis remains poor, incremental improvements in median OS were observed both in patients <60yr (3.7, 11.8, 13.8, 15.7, 19.4 mos; p<0.001) and ≥60yr (0.7, 1.6, 3.7, 5.8, 7.6 mos; p<0.001). As expected, cytogenetics predicted response to chemotherapy, with complete response (CR) rates of 90%, 66%, 58%, 38% for patients with core-binding factor (CBF) AML, cytogenetically-normal (CN) AML, complex cytogenetics, or -5/-7 abnormalities, respectively. The achievement of CR during induction remained a critical prognostic factor across decades; regimens that produced CR rates ≥60% rendered improved OS rates over those inducing CR rates in <60% of patients (53 vs 28wks; p=0.0001). Patients treated with regimens containing ≥1g/m2 versus <1g/m2 of ara-C per course rendered higher CR (65% vs 58%; p=0.0001), CR duration (67 vs 48wks; p=0.002), and median OS (55 vs 48wks; p=0.06) rates, with similar low early mortality (first 8wks) rates among patients <60yr (12% vs 13%) but higher early mortality among patients ≥60yr (30% vs 21%). When comparing idarubicin (12mg/m2x3) vs daunorubicin (45mg to 60m/m2×3) combined with equal ara-C doses, idarubicin-containing regimens induced higher CR (66% vs 52%; p=0.005) and OS (61 vs 46; p=0.06). Based on these data, we developed the AI regimen (ara-C: 1.5g/m2×3d and idarubicin: 12mg/m2×3d) in 1990's for the treatment of newly diagnosed AML (n=486; CR, CR duration, and OS rates: 61%, 63wks, and 48wks). Four agents (sorafenib, SAHA, G-CSF and tipifarnib) improved CR, CR duration, and OS rates when added to the AI backbone (compared to AI alone) amongst patients with non-CBF, non-APL AML: 84%/58wks/NR, 74%/42wks/68wks, 76%/82wks/83wks, 61%/72wks/54wks, respectively. The addition of G-CSF to AI (AIG; n=137) appeared to improve CR, CR duration, and OS rates (77%/87wks/86wks) over the AI regimens, even after removing CBF-AMLs (n=22; 76%/82wks/83wks) but not when fludarabine was substituted for idarubicin (AFG; n=413; 57%/42wks/35wks). Fludarabine-based regimens designed in the 1990's such as FA (n=290; 72%/NR/85wks) but not FAI (n=265; 54%/42wks/32wks) improved upon AI. However, when CBF-AMLs were removed, the outcomes with FA (n=159; 55%/47wks/34wks) and FAI (n=260; 54%/41wks/32wks) were both inferior to AI-based combinations (n=860; 65%/64wks/55wks). In the 2000's, the FLAG-gemtuzumab regimen improved CR, CR duration, and OS (92%/NR/NR) compared with outcomes in the 80's (89%/21mo/28mo) and 90's (90%/22mo/35mo) (Fig 1B). Similarly, the use of ATRA+ATO+/−gemtuzumab improved outcomes in APL in the 2000's (88%/NR/NR) compared with the 80's (64%/18mo/18mo) and 90's (71%/NR/126mo) (Fig 1C). Conclusions: Albeit modestly, AML outcomes have improved every decade since 1960 due to improvements in supportive care, the use of higher doses of ara-C and idarubicin (over daunorubicin). The addition of certain targeted agents to chemotherapy backbones (e.g. sorafenib, SAHA, G-CSF, tipifarnib) may further improve outcomes in non-APL, non-CBF AML. CBF-AML outcomes have improved remarkably with FLAG-gentuzumab and APL outcomes have done so with ATRA+arsenic+/−gemtuzumab. Disclosures: No relevant conflicts of interest to declare.

Prospective study to measure the impact of MMprofiler on treatment intention in newly diagnosed multiple myeloma patients (PROMMIS).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8030-8030
Author(s):  
Parameswaran Hari ◽  
Suzanne Lentzsch ◽  
David Samuel DiCapua Siegel ◽  
Saad Zafar Usmani ◽  
Binod Dhakal ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Treatment Strategies ◽  
Progression Free Survival ◽  
Risk Classification ◽  
Newly Diagnosed ◽  
Treatment Paradigm ◽  
Risk Patients ◽  
The Impact ◽  
Standard Risk

8030 Background: Multiple Myeloma (MM) is recognized as a heterogeneous group of patients with varying response and outcome of their disease, associated with various risk factors including genetic aberrations. Risk adapted treatment strategies are beginning to emerge (e.g. mSMART), which include gene expression signatures. SKY92, a 92-gene prognostic signature, classifies MM patients as “high” or “standard” risk. It has been reported to be a robust predictor for Overall and Progression Free Survival (Kuiper 2012, 2015). Here we report the preliminary impact of SKY92 on risk classification and treatment intention decisions in newly diagnosed MM patients enrolled in the PRospective Observational Multiple Myeloma Impact Study (PROMMIS). Methods: Patients with MM had their BM aspirate analyzed using the MMprofiler with SKY92. The physician completed questionnaires with his/her treatment intention, before and after knowing SKY92 results. Results: 39 MM patients were enrolled from 5 US centers. The SKY92 signature classified 15 patients (38%) as high risk. Prior to knowing SKY92 results, physicians regarded 20 (51%) patients as clinically high risk, for whom SKY92 indicated 12 patients to be standard risk. Upon revealing SKY92, 8 patients were then considered standard risk by the physician. For 2 patients with concordant high risk classification results, the confirmation of the risk classification was considered helpful. The impact of treatment intention decisions in clinical high risk patients was 40% (8 out of 20). In the 19 patients (49%) that were regarded clinically standard risk prior to knowing SKY92, SKY92 indicated 7 patients to be high risk. Physicians agreed to this classification. For 4 patients with concordant risk classification, the confirmation was found helpful. The impact of treatment intention decisions in clinical standard risk patients was 37% (7 out of 19). Conclusions: Preliminary results from the PROMMIS trial indicate that SKY92 impacts the physician’s treatment intention for 38% of patients with newly diagnosed MM. Moreover, the physicians found the SKY92 result useful for 54% of the patients. This underlines the relevance and need for assessment of SKY92 in MM patients, and associated risk stratified treatment paradigm. Clinical trial information: NCT02911571.

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