Risk Assessment for Newly Diagnosed Fit Young Patients with Multiple Myeloma in the Era of Novel Treatment Modalities: Should There Be Additional Factors Taken into Consideration??

Abstract

Panayotis Kaloyannidis, Fatema Abdulla, Enas Mutahar, Haidar Al Hashim, Salman Al Harbi, Analie Estanislao, Hani Al Hashmi Adult Hematology and Stem Cell Transplantation Department, King Fahad Specialist Hospital, Dammam, Saudi ArabiaCorrespondence: Panayotis Kaloyannidis, Adults Hematology and Stem Cell Transplantation Department, King Fahad Specialist Hospital, Ammar Bin Thabit Street, Al Muraikabat, Dammam, 31444, Saudi Arabia, Tel [phone], Fax [phone], Email [email protected]; [email protected]: The optimal treatment for young patients with high-risk newly diagnosed multiple myeloma (NDMM) remains a challenge.Methods: We retrospectively evaluated 58 NDMM patients younger than 55 years treated in our center from 2010 to 2021 with the current recommended protocols.Results: After a median follow-up of 48 months, median overall survival (OS) was not reached; however, approximately 25% of them died within 4 years after diagnosis. Advanced disease stage, presence of extramedullary disease, elevated LDH, and less than very good remission before autologous hematopoietic stem-cell transplantation adversely affected patient survival. Based on these factors, we created a risk-assessment scoring system that sufficiently discriminated young NDMM patients at risk of poor outcome. The 4-year OS was superior for patients with zero to two factors to those with three to five factors (86% vs 44%, p< 0.001).Conclusion: The proposed scoring system could be reliably used at diagnosis and at interim disease evaluation in aiming for personalized treatment for young NDMM patients.Keywords: multiple myeloma, high-risk multiple myeloma, multiple myeloma risk assessment, young newly diagnosed multiple myeloma patients

Keywords

• multiple myeloma
• high risk multiple myeloma
• multiple myeloma risk assessment
• young newly diagnosed multiple myeloma patients;