Dhakal et al reported a prognostic score for a patient with multiple myeloma undergoing autologous hematopoietic cell transplantation (AHCT). This can help to identify a patient at increased risk for early relapse. The authors are from multiple institutions in the United States and England, with data from the Center for Blood and Marrow Transplant Research (CIBMTR).
Patient selection: multiple myeloma, with autologous hematopoietic cell transplant
Parameters:
(1) cytogenetics
(2) bone marrow plasma cells (BMPCs) at time of transplant
(3) serum albumin at diagnosis
High-risk cytogenetics - one or more of the following:
(1) t(4;14)
(2) t(14;16)
(3) t(14;20)
(4) del 13q/monosomy 13
(5) del 17p
(6) 1q gain
(7) 1p del
Parameter
Finding
Points
cytogenetics
high risk
4
standard risk
2
no abnormalities
0
BMPC
< 10%
0
>= 10%
4
serum albumin
>= 3.5 g/dL
0
< 3.5 g/dL
4
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score:
• msximum score: 12 (10 highest in study population)
Score
Risk Group
Median Progression-Free Survival (PFS)
0 to 3
low
50 months
4 to 8
intermediate
29 months
>= 9
high
14 months
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