Predictors of early morbidity and mortality in newly diagnosed multiple myeloma: results from the EPICOVIDEHA survey
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Predictors of early morbidity and mortality in newly diagnosed multiple myeloma: results from the EPICOVIDEHA survey. / Mai, Elias K; Hielscher, Thomas; Bertsch, Uta; Salwender, Hans J; Zweegman, Sonja; Raab, Marc S; Munder, Markus; Pantani, Lucia; Mancuso, Katia; Brossart, Peter; Beksac, Meral; Blau, Igor W; Dürig, Jan; Besemer, Britta; Fenk, Roland; Reimer, Peter; van der Holt, Bronno; Hänel, Mathias; von Metzler, Ivana; Graeven, Ullrich; Müller-Tidow, Carsten; Boccadoro, Mario; Scheid, Christof; Dimopoulos, Meletios A; Hillengass, Jens; Weisel, Katja C; Cavo, Michele; Sonneveld, Pieter; Goldschmidt, Hartmut.
in: LEUKEMIA, Jahrgang 38, Nr. 3, 03.2024, S. 640-647.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Predictors of early morbidity and mortality in newly diagnosed multiple myeloma: results from the EPICOVIDEHA survey
AU - Mai, Elias K
AU - Hielscher, Thomas
AU - Bertsch, Uta
AU - Salwender, Hans J
AU - Zweegman, Sonja
AU - Raab, Marc S
AU - Munder, Markus
AU - Pantani, Lucia
AU - Mancuso, Katia
AU - Brossart, Peter
AU - Beksac, Meral
AU - Blau, Igor W
AU - Dürig, Jan
AU - Besemer, Britta
AU - Fenk, Roland
AU - Reimer, Peter
AU - van der Holt, Bronno
AU - Hänel, Mathias
AU - von Metzler, Ivana
AU - Graeven, Ullrich
AU - Müller-Tidow, Carsten
AU - Boccadoro, Mario
AU - Scheid, Christof
AU - Dimopoulos, Meletios A
AU - Hillengass, Jens
AU - Weisel, Katja C
AU - Cavo, Michele
AU - Sonneveld, Pieter
AU - Goldschmidt, Hartmut
N1 - © 2023. The Author(s).
PY - 2024/3
Y1 - 2024/3
N2 - Early morbidity and mortality affect patient outcomes in multiple myeloma. Thus, we dissected the incidence and causes of morbidity/mortality during induction therapy (IT) for newly diagnosed multiple myeloma (NDMM), and developed/validated a predictive risk score. We evaluated 3700 transplant-eligible NDMM patients treated in 2005-2020 with novel agent-based triplet/quadruplet IT. Primary endpoints were severe infections, death, or a combination of both. Patients were divided in a training (n = 1333) and three validation cohorts (n = 2367). During IT, 11.8%, 1.8%, and 12.5% of patients in the training cohort experienced severe infections, death, or both, respectively. Four major, baseline risk factors for severe infection/death were identified: low platelet count (<150/nL), ISS III, higher WHO performance status (>1), and age (>60 years). A risk score (1 risk factor=1 point) stratified patients in low (39.5%; 0 points), intermediate (41.9%; 1 point), and high (18.6%; ≥2 points) risk. The risk for severe infection/death increased from 7.7% vs. 11.5% vs. 23.3% in the low- vs. intermediate- vs. high-risk groups (p < 0.001). The risk score was independently validated in three trials incorporating quadruplet IT with an anti-CD38 antibody. Our analyses established a robust and easy-to-use score to identify NDMM patients at risk of severe infection/death, covering the latest quadruplet induction therapies. Trial registrations: HOVON-65/GMMG-HD4: EudraCT No. 2004-000944-26. GMMG-MM5: EudraCT No. 2010-019173-16. GMMG-HD6: NCT02495922. EMN02/HOVON-95: NCT01208766. GMMG-HD7: NCT03617731.
AB - Early morbidity and mortality affect patient outcomes in multiple myeloma. Thus, we dissected the incidence and causes of morbidity/mortality during induction therapy (IT) for newly diagnosed multiple myeloma (NDMM), and developed/validated a predictive risk score. We evaluated 3700 transplant-eligible NDMM patients treated in 2005-2020 with novel agent-based triplet/quadruplet IT. Primary endpoints were severe infections, death, or a combination of both. Patients were divided in a training (n = 1333) and three validation cohorts (n = 2367). During IT, 11.8%, 1.8%, and 12.5% of patients in the training cohort experienced severe infections, death, or both, respectively. Four major, baseline risk factors for severe infection/death were identified: low platelet count (<150/nL), ISS III, higher WHO performance status (>1), and age (>60 years). A risk score (1 risk factor=1 point) stratified patients in low (39.5%; 0 points), intermediate (41.9%; 1 point), and high (18.6%; ≥2 points) risk. The risk for severe infection/death increased from 7.7% vs. 11.5% vs. 23.3% in the low- vs. intermediate- vs. high-risk groups (p < 0.001). The risk score was independently validated in three trials incorporating quadruplet IT with an anti-CD38 antibody. Our analyses established a robust and easy-to-use score to identify NDMM patients at risk of severe infection/death, covering the latest quadruplet induction therapies. Trial registrations: HOVON-65/GMMG-HD4: EudraCT No. 2004-000944-26. GMMG-MM5: EudraCT No. 2010-019173-16. GMMG-HD6: NCT02495922. EMN02/HOVON-95: NCT01208766. GMMG-HD7: NCT03617731.
U2 - 10.1038/s41375-023-02105-6
DO - 10.1038/s41375-023-02105-6
M3 - SCORING: Journal article
C2 - 38062124
VL - 38
SP - 640
EP - 647
JO - LEUKEMIA
JF - LEUKEMIA
SN - 0887-6924
IS - 3
ER -