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Cited by 429

The DOI matches its Crossref record; 63 of the 63 references it cites were found in a registry or an index.

Second Revision of the International Staging System (R2-ISS) for Overall Survival in Multiple Myeloma: A European Myeloma Network (EMN) Report Within the HARMONY Project

Open access
D'Agostino, Mattia, Cairns, David A., Lahuerta, Juan José, Wester, Ruth, Bertsch, Uta, Waage, Anders, Zamagni, Elena, Mateos, María-Victoria, Dall'Olio, Daniele, van de Donk, Niels W.C.J., Jackson, Graham, Rocchi, Serena, Salwender, Hans, Bladé Creixenti, Joan, van der Holt, Bronno, Castellani, Gastone, Bonello, Francesca, Capra, Andrea, Mai, Elias K., Dürig, Jan, Gay, Francesca, Zweegman, Sonja, Cavo, Michele, Kaiser, Martin F., Goldschmidt, Hartmut, Hernández Rivas, Jesús María, Larocca, Alessandra, Cook, Gordon, San-Miguel, Jesús F., Boccadoro, Mario, Sonneveld, Pieter·2022·Journal of Clinical Oncology
DOI 10.1200/jco.21.02614
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Abstract

PURPOSE: Patients with newly diagnosed multiple myeloma (NDMM) show heterogeneous outcomes, and approximately 60% of them are at intermediate-risk according to the Revised International Staging system (R-ISS), the standard-of-care risk stratification model. Moreover, chromosome 1q gain/amplification (1q+) recently proved to be a poor prognostic factor. In this study, we revised the R-ISS by analyzing the additive value of each single risk feature, including 1q+. PATIENTS AND METHODS: The European Myeloma Network, within the HARMONY project, collected individual data from 10,843 patients with NDMM enrolled in 16 clinical trials. An additive scoring system on the basis of top features predicting progression-free survival (PFS) and overall survival (OS) was developed and validated. RESULTS: In the training set (N = 7,072), at a median follow-up of 75 months, ISS, del(17p), lactate dehydrogenase, t(4;14), and 1q+ had the highest impact on PFS and OS. These variables were all simultaneously present in 2,226 patients. A value was assigned to each risk feature according to their OS impact (ISS-III 1.5, ISS-II 1, del(17p) 1, high lactate dehydrogenase 1, t(4;14) 1, and 1q+ 0.5 points). Patients were stratified into four risk groups according to the total additive score: low (Second Revision of the International Staging System [R2-ISS]-I, 19.2%, 0 points), low-intermediate (II, 30.8%, 0.5-1 points), intermediate-high (III, 41.2%, 1.5-2.5 points), high (IV, 8.8%, 3-5 points). Median OS was not reached versus 109.2 versus 68.5 versus 37.9 months, and median PFS was 68 versus 45.5 versus 30.2 versus 19.9 months, respectively. The score was validated in an independent validation set (N = 3,771, of whom 1,214 were with complete data to calculate R2-ISS) maintaining its prognostic value. CONCLUSION: The R2-ISS is a simple prognostic staging system allowing a better stratification of patients with intermediate-risk NDMM. The additive nature of this score fosters its future implementation with new prognostic variables.

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Metadata

Authors
D'Agostino, M., Cairns, D. A., Lahuerta, J. J., Wester, R., Bertsch, U., Waage, A., Zamagni, E., Mateos, M.-V., Dall'Olio, D., van de Donk, N. W. C. J., Jackson, G., Rocchi, S., Salwender, H., Bladé Creixenti, J., van der Holt, B., Castellani, G., Bonello, F., Capra, A., Mai, E. K., Dürig, J., Gay, F., Zweegman, S., Cavo, M., Kaiser, M. F., Goldschmidt, H., Hernández Rivas, J. M., Larocca, A., Cook, G., San-Miguel, J. F., Boccadoro, M., & Sonneveld, P.
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2022-10-10
Volume
40
Issue
29
Pages
3406-3418
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.21.02614
OpenAlex
W4281397013
Cited by
429
References
63
FWCI
54.94
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: Second Revision of the International Staging System (R2-ISS) for Overall Survival in Multiple Myeloma: A European Myeloma Network (EMN) Report Within the HARMONY Project. https://app.cochat.ai/papers/10.1200/jco.21.02614
The paper
D'Agostino, M., Cairns, D. A., Lahuerta, J. J., Wester, R., Bertsch, U., Waage, A., Zamagni, E., Mateos, M.-V., Dall'Olio, D., van de Donk, N. W. C. J., Jackson, G., Rocchi, S., Salwender, H., Bladé Creixenti, J., van der Holt, B., Castellani, G., Bonello, F., Capra, A., Mai, E. K., . . . Sonneveld, P. (2022). Second Revision of the International Staging System (R2-ISS) for Overall Survival in Multiple Myeloma: A European Myeloma Network (EMN) Report Within the HARMONY Project. Journal of Clinical Oncology. https://doi.org/10.1200/jco.21.02614

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.