For a study, the researchers sought to determine how achieving a complete response (CR) within 2 years of diagnosis affected the predictive value of fluorescence in situ hybridization (FISH) and risk according to the International Staging System (ISS), as well as look at other predictors of outcome among those who achieved a CR in a routine clinical setting. They looked at 1,869 newly diagnosed multiple myeloma (MM) patients who had more than or equal to 2 monoclonal protein immunofixation investigations in the blood and urine within 24 months of diagnosis, and those who had more than or similar to 2 negative serum and urine immunofixation were considered to have achieved CR. At 24 months, the median progression-free survival (PFS) for CR versus non-CR patients was 29.8 months versus 20.9 months (p≤.0002), and the median overall survival (OS) was 104 months versus 70 months (P<.0001). After correcting for FISH, ISS, sex, transplant status, and heavy chain involvement, the impact of establishing a CR was sustained. In patients who achieved a CR, baseline FISH and ISS stage had no effect on PFS or OS. Age more than 75 years, male gender, hypoalbuminemia, and non-immunoglobulin G involved heavy chain were all revealed to be predictive of poorer OS in the CR group. The outcomes showed that achieving CR after 2 years of diagnosis was related to improved survival outcomes and neutralization of the effects of FISH and ISS risk, confirming results from clinical trials in a clinical practice cohort.
Source:onlinelibrary.wiley.com/doi/10.1002/ajh.26439
