Association between baseline Controlling Nutritional Status Score and clinical outcomes of patients with multiple myeloma

2021 ◽  
pp. 1-7
Author(s):  
Xin Zhou ◽  
Yan Lu ◽  
Jun Xia ◽  
Jingjue Mao ◽  
Jing Wang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Nutritional Status ◽  
Clinical Outcomes ◽  
Remission Rate ◽  
Staging System ◽  
Prognostic Impact ◽  
Entire Cohort ◽  
International Staging System ◽  
Prognostic Risk Factors ◽  
Conut Score

BACKGROUND: The Controlling Nutritional Status (CONUT) score, a novel immuno-nutritional index, was reported as a predictor of overall survival (OS) in some tumors. OBJECTIVE: We aimed to investigate the association between baseline CONUT Score and clinical outcomes in patients with multiple myeloma (MM) METHODS: We performed a retrospective analysis of 245 patients with MM. The CONUT score was determined prior to therapy. RESULTS: Among the entire cohort, the complete remission rate was markedly higher in the low-CONUT (⩽ 3) group compared to the mid-CONUT (4–9) group or high-CONUT (> 9) group (44.1% vs 25.8%, P= 0.039; 44.1% vs 12.5%, P= 0.002). Patients with CONUT score > 9 had significant poor prognosis, and CONUT score ⩽ 3 group showed better survival outcome than other groups in OS (P< 0.001). Besides, we stratified the patients by combining International Staging System (ISS) stage and CONUT score in a model, and found that CONUT score could improve the prognostic impact of ISS stages on OS In multivariate analysis, older age (⩾ 70 years) and a high CONUT score (⩾ 4) were independent prognostic risk factors for OS. CONCLUSIONS: The CONUT score was a predictor of OS in MM patients especially in cases with both low ISS staging and CONUT score. The baseline CONUT score may be an early and practical indicator of the efficacy of anti-myeloma treatment.

A Staged Approach to the Use of Bortezomib/Thalidomide/Dexamethasone (VTD) in Multiple Myeloma Patients with Suboptimal Initial Cytoreduction Led to a High Complete Remission Rate

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5202-5202
Author(s):  
Chor Sang James Chim ◽  
Raymond Liang
Keyword(s):  
Multiple Myeloma ◽  
Complete Remission ◽  
Remission Rate ◽  
Staging System ◽  
Hematopoietic Stem ◽  
Stage Disease ◽  
Tumor Load ◽  
International Staging System ◽  
Staged Approach

Abstract Autologous hematopoietic stem cell transplantation (AHSCT) and bortezomib are the two most important advances in the treatment of multiple myeloma (MM) in the last decade. Autologous HSC harvest is preferably performed at complete remission (CR) or after maximal reduction of myeloma tumor load. Owing to the high cost of bortezomib, we devised a total therapy incorporating VAD (vincristine, adriamycin, dexamethasone), followed by VTD in those with inadequate cytoreduction (i.e. &lt;75% reduction in paraprotein) to maximize eradication of myeloma cells in the marrow prior to HSC harvest. Those achieving &gt;75% paraprotein reduction proceeded to AHSCT directly. Those with measurable disease after the first AHSCT proceeded to second AHSCT. Response was based on the EBMT criteria (Blade et al, 1998). There were 16 patients with a median age of 50 years (33–64). Majority had advanced stage disease by International staging system. After VAD, 6 patients had &gt;75% response (&gt;90% response, n=3; 75%–90% response, n=3) and hence proceeded to first AHSCT directly. The other 10 patients had VTD salvage therapy, which upgraded response in 9 cases. After VAD and VTD treatments, there were 2, 6,7 and 1 patients achieving CR, &gt;90% response, 75%–90% response and no response respectively. Thirteen patients proceeded to the first AHSCT, which rendered upgrading of response in 9 patients (69%) with CR/near CR in 7 cases (54%) and &gt;90% response in 4 cases (31%). The latter 4 patients proceeded to second AHSCT, resulting in CR/near CR in 9 cases (70%) and &gt;90% in 2 cases (15%). Of the 11 patients with &gt;90% response after first and/or second AHSCT, 5 patients had maintained response with continual CR in 4 cases, whereas 6 patients relapsed (with asymptomatic disease in 4 cases and fatality in 2 cases). Therefore, this strategy of employing bortezomib only in those with insufficient cytoreduction achieved a high CR/near CR rate comparable to that with upfront bortezomib use. However, the frequent relapse implied that the quality of CR is equally important. Moreover, the aggressive fatal relapse in CR patients demonstrated a biologically aggressive subgroup in which CR might be inadequate.

scholarly journals Comprehensive evaluation of the revised international staging system in multiple myeloma patients treated with novel agents as a primary therapy

2017 ◽  
Vol 92 (12) ◽  
pp. 1280-1286 ◽  
Author(s):  
Hyungwoo Cho ◽  
Dok Hyun Yoon ◽  
Jung Bok Lee ◽  
Sung-Yong Kim ◽  
Joon Ho Moon ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Comprehensive Evaluation ◽  
Staging System ◽  
Novel Agents ◽  
Primary Therapy ◽  
International Staging System

Chronic kidney disease stage 5 as the prognostic complement of International Staging System for multiple myeloma

2011 ◽  
Vol 88 (2) ◽  
pp. 159-166 ◽  
Author(s):  
Liang-Tsai Hsiao ◽  
Ching-Fen Yang ◽  
Sheng-Hsiang Yang ◽  
Jyh-Pyng Gau ◽  
Yuan-Bin Yu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Multiple Myeloma ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Staging System ◽  
Disease Stage ◽  
International Staging System

scholarly journals Prediction of high- and low-risk multiple myeloma based on gene expression and the International Staging System

Blood ◽  
2015 ◽  
Vol 126 (17) ◽  
pp. 1996-2004 ◽  
Author(s):  
Rowan Kuiper ◽  
Mark van Duin ◽  
Martin H. van Vliet ◽  
Annemiek Broijl ◽  
Bronno van der Holt ◽  
...  
Keyword(s):  
Gene Expression ◽  
Multiple Myeloma ◽  
Prognostic Value ◽  
Staging System ◽  
Risk Classification ◽  
Low Risk ◽  
Key Points ◽  
International Staging System

Key Points Combination of ISS and the EMC92 gene classifier is a novel clinically applicable risk classification for survival in multiple myeloma. ISS has clear independent additive prognostic value in combination with GEP classifiers or FISH markers.

Impact of Serum Albumin and B2-Microglobulin level on 2-Year Overall Survival among Newly Diagnosed Multiple Myeloma Patients: A retrospective Study

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Sherian Salama ◽  
Rodaina Yousef ◽  
Asma Al Olama ◽  
Mahmoud Marashi ◽  
Hana Salama ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Serum Albumin ◽  
United Arab Emirates ◽  
Staging System ◽  
Albumin Level ◽  
Age At Diagnosis ◽  
Newly Diagnosed ◽  
International Staging System ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Background: Multiple myeloma accounts for 1% of all cancers and approximately 10% of all hematologic malignancies. Evaluation and initial staging of the disease is made once the diagnosis is confirmed. The recommended staging system is the International Staging System (ISS). Which determines the Myeloma prognosis by 2 factors: beta-2 Microglobulin and Serum albumin. Goal and Objective: The main goal of this study is to assess the effect of Beta-2 microglobulin and Serum albumin on patient’s survival rate with Multiple Myeloma. The secondary objective is to compare the age at diagnosis with other literature. Methodology: The current study was carried out in Hematology Unit, Dubai Hospital, Dubai, Dubai Health Authority (DHA), United Arab Emirates. Chart review was done retrospectively for 49 newly diagnosed patients with Multiple Myeloma diagnosed between the period 2012-2016. Purposive sample was used to those patients who met the inclusion criteria of this study, to be diagnosed and treated in DH. diagnosed and received regular treatment in Dubai Hospital. Results: Medina follow-up of the patients in this study was (12.8) months. The 2-year overall survival rate for patients with Multiple Myeloma (n = 49) was approximately 80%. While, the 2-year OS rate based on Albumin level. Patients with albumin level > 3.5 mg\dl was significantly higher compared to those who had an albumin level <3.5 mg\dl. 100%, 65% respectively, P = 0.033. Moreover, the 2-year OS rate in terms B2MG level. Patients who had a B2MG < 3.5 mg\dl OS was slightly higher compared to those who had (3.5-5.5 and 5.5 mg\dl). OS rate approximately 85 %, 80 % and 75 respectively, P = .737 Conclusion: Multiple myeloma (MM) is a very heterogeneous disease. For this reason, various prognostic factors and staging systems have been developed to predict the disease outcome. International Staging System (ISS) is very useful in determine the survival based on serum β2- microglobulin and serum albumin levels. The age at diagnosis in Dubai hospital, United Arab Emirates is much younger compared to other studies conducted worldwide. The sample used in the study was also highly diverse in terms of culture and nationality. Such diversity is largely typical in Gulf especially in United Arab Emirates. Therefore, this can play important role in age at diagnosis.

High Expression Levels of Long Noncoding RNA Small Nucleolar RNA Host Gene 18 and Semaphorin 5A Indicate Poor Prognosis in Multiple Myeloma

2019 ◽  
Vol 143 (3) ◽  
pp. 279-288 ◽  
Author(s):  
Ling-Juan Huang ◽  
Ying Shen ◽  
Ju Bai ◽  
Fang-Xia Wang ◽  
Yuan-Dong Feng ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Noncoding Rna ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Staging System ◽  
High Expression ◽  
Newly Diagnosed ◽  
High Expression Group ◽  
International Staging System ◽  
Nucleolar Rna

Background: The aim of this study was to detect the expression of long noncoding RNA small nucleolar RNA host gene 18 (SNHG18) andsemaphorin 5A (SEMA5A) genes in multiple myeloma (MM) patients and to explore the correlation of the expression of these genes with the clinical characteristics and prognosis of MM patients. Methods: Forty-seven newly diagnosed MM, 18 complete remission MM, 13 refractory/relapse MM, and 22 iron deficiency anemia (serving as control) samples were extracted at the Department of Hematology, Second Affiliated Hospital of Xian Jiaotong University between January 2015 and December 2016. The clinical features of the MM patients are summarized. Real-time quantitative PCR was performed to analyze the relative expression levels of the SNHG18 and SEMA5Agenes. The clinical characteristics and overall survival (OS) of the MM patients were statistically analyzed while measuring different levels of SNHG18 and SEMA5Agene expression. At the same time, the correlation between the expression of SNHG18 and SEMA5A was also analyzed. Results: The analysis confirmed that SNHG18 and its possible target gene SEMA5A were both highly expressed in newly diagnosed MM patients. After analyzing the clinical significance of SNHG18 and SEMA5A in MM patients, we found that the expression of SNHG18 and SEMA5A was related to the Durie-Salmon (DS), International Staging System (ISS), and Revised International Staging System (R-ISS) classification systems, and the Mayo Clinic Risk Stratification for Multiple Myeloma (mSMART; p < 0.05). Moreover, we observed a significant difference in OS between the SNHG18/SEMA5A high expression group and the low expression group. We found a positive correlation between SNHG18 and SEMA5A expression (r = 0.709, p < 0.01). Surprisingly, the expected median OS times of both the SNHG18 and SEMA5Ahigh expression groups were significantly decreased, which was in contrast to those of both the SNHG18 and SEMA5Alow expression groups and the single-gene high expression group (p < 0.05). Conclusion: High expression of both SNHG18 and SEMA5A is associated with poor prognosis in patients with MM.

scholarly journals Early mortality in elderly patients undergoing treatment for multiple myeloma in real-world practice

2018 ◽  
Vol 46 (6) ◽  
pp. 2230-2237
Author(s):  
Jun Xia ◽  
Lingling Wang ◽  
Xin Zhou ◽  
Jing Wang ◽  
Huan Wang ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Lactate Dehydrogenase ◽  
Elderly Patients ◽  
Real World ◽  
Staging System ◽  
Early Mortality ◽  
Stage Iii ◽  
Newly Diagnosed ◽  
International Staging System ◽  
High Lactate

Objectives This study was performed to analyze the risk factors for early mortality (EM) in elderly patients undergoing treatment for multiple myeloma (MM) in real-world clinical practice. Methods Retrospective data from 108 elderly patients who were newly diagnosed with MM from January 2007 to July 2015 were analyzed in a single hematology center. EM was defined as death of any cause within 12 months after diagnosis. A multivariate regression model was used to evaluate EM. Results EM occurred in 16 (14.8%) elderly patients with newly diagnosed MM. The most common cause of death was infection (10/16, 62.5%). In the multivariate analysis, only an age of ≥75 years, International Staging System (ISS) stage III disease, and high lactate dehydrogenase concentration were significantly and independently associated with EM. Conclusion Our results suggest that infection is the leading cause of EM in elderly patients with MM. An age of ≥75 years, ISS stage III disease, and a high lactate dehydrogenase concentration are significant predictors of EM. We should further target this higher-risk patient population to define personalized therapy with which to improve outcomes.

Sign in / Sign up

Export Citation Format

Share Document