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International Staging System predicts prognosis of Chinese patients with multiple myeloma across different calendar periods with application of novel agents

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Abstract

The applicability of the International Staging System (ISS) for Chinese patients with multiple myeloma (MM) has not been demonstrated, especially with respect to treatments with novel agents. Newly diagnosed MM patients at Taipei Veterans General Hospital were enrolled between 1996 and 2007. Data regarding clinical features, laboratory tests, and outcome at last follow-up were collected. A total of 389 MM patients (71% male) were enrolled, with median age of 71 years. At diagnosis, 72.7% had Durie–Salmon (DS) stage III disease, 56.2% had ISS stage III disease, and 34% had serum creatinine ≧2.0 mg/dL. Compared with patients diagnosed in the first calendar period 1996–2001, the patients of the second calendar period 2002–2007 were older and more of these patients had received novel agents, especially thalidomide. The median overall survival period was 20.5 months, with a significant increase of patients in the second calendar period (15.3 and 28.2 months, respectively; P = 0.002), especially for those with ISS stages I and II. In the Cox proportion model, elevated serum β2 microglobulin at diagnosis (≧3.5 mg/L), old age (≧65 years), and impaired renal function were found to be independently associated with poor survival. Over the entire period, the ISS was found to be effective in providing an accurate prognosis with respect to different ages and calendar periods. This is the first study to show the applicability of ISS for Chinese patients with MM, especially for those who had received thalidomide.

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Acknowledgments

This study was supported by grants from the Taiwan Clinical Oncology Research Foundation, Taipei Veterans General Hospital (V97B2-010, V98B2-010, V98ER2-016, V99ER2-003), and National Science Council (NSC), Taiwan (NSC95-2745-B-075-008 and 96-2321-B-075-008).

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Authors and Affiliations

  1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Taipei, 112, Taiwan

    Sheng-Hsiang Yang, Hao-Wei Teng, Ying-Chung Hong, Chun-Yu Liu, Yuan-Bin Yu, Jyh-Pyng Gau, Jin-Hwang Liu, Po-Min Chen, Cheng-Hwai Tzeng & Liang-Tsai Hsiao

  2. School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Sheng-Hsiang Yang, Hao-Wei Teng, Ying-Chung Hong, Chun-Yu Liu, Yuan-Bin Yu, Ching-Fen Yang, Jyh-Pyng Gau, Jin-Hwang Liu, Tai-Jay Chang, Po-Min Chen, Tzeon-Jye Chiou, Cheng-Hwai Tzeng & Liang-Tsai Hsiao

  3. Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan

    Ching-Fen Yang

  4. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan

    Tai-Jay Chang

  5. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan

    Jeffrey J. Y. Yen

  6. Division of Transfusion Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Tzeon-Jye Chiou

  7. Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Liang-Tsai Hsiao

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  1. Sheng-Hsiang Yang
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Correspondence to Liang-Tsai Hsiao.

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Yang, SH., Teng, HW., Hong, YC. et al. International Staging System predicts prognosis of Chinese patients with multiple myeloma across different calendar periods with application of novel agents. Ann Hematol 91, 93–102 (2012). https://doi.org/10.1007/s00277-011-1251-y

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  • DOI: https://doi.org/10.1007/s00277-011-1251-y

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