Journal article
A Risk Stratification System in Myeloma Patients with Autologous Stem Cell Transplantation
Cancers, Vol.16(6), 1116
03/11/2024
DOI: 10.3390/cancers16061116
PMCID: PMC10969019
PMID: 38539451
Abstract
Autologous stem cell transplantation (ASCT) has been a mainstay in myeloma treatment for over three decades, but patient prognosis post-ASCT varies significantly. In a retrospective study of 5259 patients with multiple myeloma (MM) at the University of Arkansas for Medical Sciences undergoing ASCT with a median 57-month follow-up, we divided the dataset into training (70%) and validation (30%) subsets. Employing univariable and multivariable Cox analyses, we systematically assessed 29 clinical variables, identifying crucial adverse prognostic factors, such as extended duration between MM diagnosis and ASCT, elevated serum ferritin, and reduced transferrin levels. These factors could enhance existing prognostic models. Additionally, we pinpointed significant poor prognosis markers like high serum calcium and low platelet counts, though they are applicable to a smaller patient population. Utilizing seven easily accessible high-risk variables, we devised a four-stage system (ATM4S) with primary stage borders determined through K-adaptive partitioning. This staging system underwent validation in both the training dataset and an independent cohort of 514 ASCT-treated MM patients from the University of Iowa. We also explored cytogenetic risk factors within this staging system, emphasizing its potential clinical utility for refining prognostic assessments and guiding personalized treatment approaches.
Details
- Title: Subtitle
- A Risk Stratification System in Myeloma Patients with Autologous Stem Cell Transplantation
- Creators
- Wancheng Guo - Winthrop Rockefeller FoundationChristopher Strouse - University of IowaDavid Mery - Winthrop Rockefeller FoundationEric R Siegel - University of Arkansas for Medical SciencesManit N Munshi - Winthrop Rockefeller FoundationTimothy Cody Ashby - University of Arkansas for Medical SciencesYan Cheng - Winthrop Rockefeller FoundationFumou Sun - Winthrop Rockefeller FoundationVisanu Wanchai - University of Arkansas for Medical SciencesZijun Zhang - Winthrop Rockefeller FoundationClyde Bailey - Winthrop Rockefeller FoundationDaisy V Alapat - University of Arkansas for Medical SciencesHongling Peng - Second Xiangya Hospital of Central South UniversitySamer Al Hadidi - University of Arkansas for Medical SciencesSharmilan Thanendrarajan - Winthrop Rockefeller FoundationCarolina Schinke - Winthrop Rockefeller FoundationMaurizio Zangari - University of Arkansas for Medical SciencesFrits van Rhee - University of Arkansas for Medical SciencesGuido Tricot - Winthrop Rockefeller FoundationJohn D Shaughnessy Jr - University of Arkansas for Medical SciencesFenghuang Zhan - Winthrop Rockefeller Foundation
- Resource Type
- Journal article
- Publication Details
- Cancers, Vol.16(6), 1116
- DOI
- 10.3390/cancers16061116
- PMID
- 38539451
- PMCID
- PMC10969019
- ISSN
- 2072-6694
- eISSN
- 2072-6694
- Grant note
- 1R01CA236814-01A1 / NCI NIH HHS 3R01-CA236814-03S1 / NCI NIH HHS U54CA272691-01 / NCI NIH HHS U54 CA272691 / NCI NIH HHS R01 CA236814 / NCI NIH HHS
- Language
- English
- Date published
- 03/11/2024
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984577110502771
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