Development and validation of an individualized and weighted Myeloma Prognostic Score System (MPSS) in patients with newly diagnosed multiple myeloma

Xuehan Mao, Wenqiang Yan, David Mery, Jiahui Liu, Huishou Fan, Jingyu Xu, Yan Xu, Weiwei Sui, Shuhui Deng, Dehui Zou, Chenxing Du, Shuhua Yi, Frits van Rhee, Bart Barlogie, John D. Shaughnessy, Kenneth C. Anderson, Fenghuang Zhan, Lugui Qiu, Gang An

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Current standard predictive models of disease risk do not adequately account for the heterogeneity of survival outcomes in patients with new-diagnosed multiple myeloma (NDMM). In this retrospective, multicohort study, we collected clinical and genetic data from 1792 NDMM patients and identified the prognostic impact of all features. Using the top-ranked predictive features, a weighted Myeloma Prognostic Score System (MPSS) risk model was formulated and validated to predict overall survival (OS). In the training cohort, elevated lactate dehydrogenase level (LDH), International Staging System (ISS) Stage III, thrombocytopenia, and cumulative high-risk cytogenetic aberration (HRA) numbers were found to have independent prognostic significance. Each risk factor was defined as its weighted value respectively according to their hazard ratio for OS (thrombocytopenia 2, elevated LDH 1, ISS III 2, one HRA 1, and ≥2 HRA 2, points). Patients were further stratified into four risk groups: MPSS I (22.5%, 0 points), II (17.6%, 1 points), III (38.6%, 2–3 points), and IV (21.3%, 4–7 points). MPSS risk stratification showed optimal discrimination, as well as calibration, of four risk groups with median OS of 91.0, 69.8, 45.0, and 28.0 months, for patients in MPSS I to IV groups (p <.001), respectively. Importantly, the MPSS model retained its prognostic value in the internal validation cohort and an independent external validation cohort, and exhibited significant risk distribution compared with conventional prognostic models (R-ISS, R2-ISS, and MASS). Utilization of the MPSS model in clinical practice could improve risk estimation in NDMM patients, thus prompting individualized treatment strategies.

Original languageEnglish
Pages (from-to)523-533
Number of pages11
JournalAmerican Journal of Hematology
Volume99
Issue number4
DOIs
StatePublished - Apr 2024
Externally publishedYes

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