Related Experiment Video
Updated: Oct 11, 2025
An Organotypic High Throughput System for Characterization of Drug Sensitivity of Primary Multiple Myeloma Cells
Published on: July 15, 2015
Development of a new risk stratification system for patients with newly diagnosed multiple myeloma using R-ISS and
Hee Jeong Cho1, Sung-Hoon Jung2, Jae-Cheol Jo3
1Department of Hematology-Oncology, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, South Korea.
Abstract:
In multiple myeloma (MM), a high number of focal lesions (FL) detected using positron emission tomography/computed tomography (PET/CT) was found to be associated with adverse prognosis. To design a new risk stratification system that combines the Revised International Staging System (R-ISS) with FL, we analyzed the data of 380 patients with newly diagnosed MM (NDMM) who underwent 18F-fluorodeoxyglucose (18F-FDG) PET/CT upon diagnosis. The K-adaptive partitioning algorithm was adopted to define subgroups with homogeneous survival. The combined R-ISS with PET/CT classified NDMM patients into four groups: R-ISS/PET stage I (n = 31; R-ISS I with FL ≤ 3), stage II (n = 156; R-ISS I with FL > 3 and R-ISS II with FL ≤ 3), stage III (n = 162; R-ISS II with FL > 3 and R-ISS III with FL ≤ 3), and stage IV (n = 31; R-ISS III with FL > 3). The 2-year overall survival rates for stages I, II, III, and IV were 96.7%, 89.8%, 74.7%, and 50.3%. The 2-year progression-free survival rates were 84.1%, 64.7%, 40.8%, and 17.1%, respectively. The new R-ISS/PET was successfully validated in an external cohort. This new system had a remarkable prognostic power for estimating the survival outcomes of patients with NDMM. This system helps discriminate patients with a good prognosis from those with a poor prognosis more precisely.
Insights
A new risk stratification system combining the Revised International Staging System (R-ISS) with positron emission tomography/computed tomography (PET/CT) focal lesion counts improves prognosis prediction for newly diagnosed multiple myeloma (NDMM) patients. This R-ISS/PET system accurately identifies patients with good or poor survival outcomes.
Area of Science:
- Oncology
- Nuclear Medicine
- Medical Imaging
Background:
- High focal lesion (FL) counts on positron emission tomography/computed tomography (PET/CT) indicate poor prognosis in multiple myeloma (MM).
- Existing staging systems may not fully capture prognostic nuances in newly diagnosed multiple myeloma (NDMM).
Purpose of the Study:
- To develop and validate a novel risk stratification system for NDMM by integrating the Revised International Staging System (R-ISS) with FL burden from PET/CT.
- To enhance prognostic accuracy for survival outcomes in NDMM patients.
Main Methods:
- Analysis of data from 380 newly diagnosed multiple myeloma (NDMM) patients who underwent 18F-fluorodeoxyglucose (18F-FDG) PET/CT.
- Application of the K-adaptive partitioning algorithm to define survival subgroups.
- Development of the R-ISS/PET staging system combining R-ISS and FL counts.
- Validation in an external patient cohort.
Main Results:
- The R-ISS/PET system classified NDMM patients into four distinct stages (I-IV) with significantly different survival rates.
- Two-year overall survival rates ranged from 96.7% (Stage I) to 50.3% (Stage IV).
- Two-year progression-free survival rates ranged from 84.1% (Stage I) to 17.1% (Stage IV).
Conclusions:
- The novel R-ISS/PET staging system demonstrates significant prognostic power for survival outcomes in NDMM.
- This integrated approach provides more precise discrimination between good and poor prognosis patients compared to R-ISS alone.
- The R-ISS/PET system offers a valuable tool for refining risk stratification in NDMM management.
More Related Videos
07:15Machine Learning Algorithms for Early Detection of Bone Metastases in an Experimental Rat Model
Published on: August 16, 2020
10:28Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018