文章：

评估冒烟型多发性骨髓瘤风险分层评分在诊断后连续应用的预后价值

Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis

原文发布日期：2021-11-26

DOI: 10.1038/s41408-021-00569-2

类型: Article

开放获取: 是

英文摘要：

The Mayo-2018 smoldering multiple myeloma (SMM) risk score is used routinely in the clinical setting but has only been validated at diagnosis. In SMM patients, the progression risk decreases over time. However, the utility of applying risk stratification models after diagnosis is unknown. We retrospectively studied 704 SMM patients and applied the Mayo 2018 and IMWG-2020 risk stratification models at annual landmark timepoints up to 5 years post diagnosis. The Mayo-2018 and IMWG-2020 models reliably stratified patients based on progression risk when applied post diagnosis. The respective 2-year progression risk in Mayo-2018 high risk patients versus IMWG-2020 intermediate-high risk patients was 51% versus 62% at the 1-year landmark and 47% versus 45% at the 4-year landmark. We showed that patients categorized at Mayo-2018 high-risk at follow-up had a similar risk of progression if the baseline risk assessment was low-intermediate versus high-risk (HR 1.04, 95% CI 0.46–2.36, p = 0.931 at 5-year landmark). Patients migrating to a higher risk category during follow up had a higher progression risk compared to patients with stable/decreased risk categorization. Our findings support the use of these risk scores post-diagnosis and suggest that patients evolving to a high-risk category may benefit from early intervention therapeutic approaches.
 

摘要翻译： 

Mayo-2018冒烟型多发性骨髓瘤风险评分已常规应用于临床，但仅在其初诊时得到验证。冒烟型多发性骨髓瘤患者的进展风险会随时间推移而降低，但诊断后应用风险分层模型的有效性尚未明确。我们回顾性研究了704例冒烟型多发性骨髓瘤患者，在诊断后至5年内的年度时间点应用Mayo-2018和IMWG-2020风险分层模型进行评估。结果显示，这两种模型在诊断后应用时，仍能可靠地根据进展风险对患者进行分层。在诊断后1年时间点，Mayo-2018高危患者与IMWG-2020中高危患者的2年进展风险分别为51%和62%；至4年时间点，该风险分别降至47%和45%。研究发现，在随访中被归为Mayo-2018高危的患者，无论其基线风险评估为低中危还是高危，其进展风险均相似（5年时间点风险比1.04，95%置信区间0.46–2.36，p=0.931）。与风险分层保持稳定或降低的患者相比，在随访期间风险等级升高的患者具有更高的疾病进展风险。本研究结果支持这两种风险评分在诊断后的应用价值，并提示进展为高危类别的患者可能从早期干预治疗中获益。

原文链接：

Assessing the prognostic utility of smoldering multiple myeloma risk stratification scores applied serially post diagnosis