-Author name in bold denotes the presenting author
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1906 The Impact of Dynamic Assessment of Risk Stratification at the Time of Disease Progression in Patients with Multiple Myeloma

Program: Oral and Poster Abstracts
Session: 652. Multiple Myeloma and Plasma Cell Dyscrasias: Clinical and Epidemiological: Poster I
Hematology Disease Topics & Pathways:
Research, adult, Clinical Practice (Health Services and Quality), Clinical Research, Plasma Cell Disorders, Combination therapy, Diseases, real-world evidence, Therapies, Lymphoid Malignancies, Study Population, Human
Saturday, December 10, 2022, 5:30 PM-7:30 PM

Huishou Fan1,2,3*, Wenqiang Yan4*, Jingyu Xu5*, Chenxing Du, MD6*, Weiwei Sui7*, Shuhui Deng, MD8*, Dehui Zou8*, Lugui Qiu9 and Gang An, MD10*

1Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
2National Clinical Research Center for Blood Diseases, Tianjin, China
3Institute of Hematology & Blood Diseases Hospital, Tianjin, Cocos (Keeling) Islands
4State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical Colleg, Tianjin, China
5State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical Colleg, TianJin, China
6State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, TIANJIN, China
7State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Blood Diseases Hospital & Institute of Hematology, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
8State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences &Peking Union Medical College, Tianjin, China
9Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
10State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China

Abstract

Objective:Staging of multiple myeloma(MM) patients at diagnosis predicts survival but the utility of applying them to restaging at disease progression has not been fully explored. Here, we investigate the prognostic impact of dynamic assessment of risk stratification.

Methods: We conducted this retrospective study to evaluate the prognostic impacts of staging and restaging among 263 newly diagnosed -progression paired patients diagnosed between 24 March 2013 and 2 December 2019. Currently used ISS and RISS were applied for dynamic assessment of risk stratification both at diagnosis and progression.

Results: 263 and 257 patients had Staging data for ISS and RISS at diagnosis while 245 and 184 patients were available for ISS and RISS restaging at progression .By restaging the ISS at progression, the median post-progression survival of patients of stage I, II, III was 44.2, 21.7 and 11.6 months, respectively (P﹤0.0001) and the median overall survival (mOS) was 69.8, 53.9 and 35.2 months in patients who stage had I, II, III disease, respectively (P﹤0.001). By restaging the RISS at progression, the median post-progression survival of stage I,II,III was 50.3, 22.2 and 11.4 months, respectively(P﹤0.0001), the mOS of stage I, II, III was 89.3,57.8 and 25.2 months in patients who stage had I, II, III disease, respectively (P﹤0.001). Among patients with available data on staging and restaging, migrated to advanced ISS/RISS stages or maintained ISS/RISS III disease at progression associated with dismal post-progression survival and OS. Multivariate analysis showed that the stage at the time of progression was independent of stage at diagnosis and first line ASCT and was an independent poor prognostic factor for post-progression survival and OS.

Conclusion: It is feasible for risk stratification reassessment at progression by using ISS and RISS. The prognostic significance of restaging at progression can overcome the prognostic value of staging at diagnosis, patients who migrated to higher stage predicts poor prognosis.

Disclosures: Qiu: Janssen: Consultancy, Speakers Bureau; AstraZeneca: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Roche: Consultancy, Speakers Bureau; AbbVie: Consultancy, Speakers Bureau; BeiGene: Consultancy, Speakers Bureau.

*signifies non-member of ASH