Novel Prognostic Model Identifies Risk of Relapse for Multiple Myeloma Patients Following Transplantation

A novel prognostic scoring system can identify patients with multiple myeloma (MM) at risk for early relapse following autologous hematopoietic cell transplantation (AHCT), according to a study published in the British Journal of Haematology.

Researchers developed their prognostic model by assessing 2,528 patients with MM who underwent upfront AHCT between 2008 and 2017. Subsequently, a Cox model was used to identify factors of progression and relapse in a training subset of 1,246 patients, while a weighted score combining these factors was assigned to a validation group of 774 patients.

The researchers assigned high-risk cytogenetics four points each; albumin at diagnosis <3.5 g/dL (two points); standard risk cytogenetics (one point), and no cytogenetics abnormality, bone marrow plasma cells <10% at AHCT, and albumin ≥3.5 g/dL at diagnosis (zero points each).

According to the results, a three-category system with low (0-3), intermediate (4-8), and high risk (9-10) showed three-year progression-free survival of 58% in low (95% confidence interval [CI], 52-63), 49% in intermediate (95% CI, 43-56), and 31% in high risk (95% CI, 12-51; P<0.001). Three-year overall survival was 88% (95% CI, 84-91), 81% (95% CI, 76-86), and 64% (95% CI, 39-80; P<0.001), respectively.