Related Experiment Video
Updated: Aug 25, 2026
Constructing and Visualizing Models using Mime-based Machine-learning Framework
Published on: July 22, 2025
Myeloma Elderly Prognostic Score (MEPS): A Proposed Prognostic Score Integrating Age, Renal Function, Performance
Eirini Katodritou1, Bruna Velosa Ferreira2, Efstathios Kastritis3
1Hematology-Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece.
Abstract:
Established disease-centered prognostic systems may be less tailored to elderly/non-transplant-eligible (NTE) patients with multiple myeloma (MM), in whom host-related factors such as age, performance status, and renal function strongly influence all-cause outcomes. We developed and evaluated the Myeloma Elderly Prognostic Score (MEPS), a pragmatic four-factor score integrating age ≥ 75 years, renal function < 40 by eGFR or available creatinine clearance (CrCl), ECOG performance status ≥ 2, and ultra-high-risk cytogenetics, using baseline registry data from 881 newly diagnosed NTE MM patients from Greece, with OS analyses performed in the 878 patients with evaluable survival follow-up, and externally evaluated it in an independent Portuguese cohort. In the Greek OS-evaluable cohort, 485 deaths were observed. Median OS by MEPS group was 96, 65, 39, and 15.3 months for scores 0, 1, 2, and ≥ 3, respectively. In a baseline score-level Cox model, each ordinal MEPS category increase was associated with inferior OS (HR 1.74, 95% CI 1.58-1.92; p < 0.001). MEPS showed higher OS discrimination than R2-ISS in the Greek cohort (C-index 0.655 vs. 0.602; bootstrap delta 0.053, 95% CI 0.021-0.085). The Portuguese validation dataset included 300 patients, of whom 290 were evaluable for the primary OS analysis, with 151 deaths. Median OS was 59.6 months (95% CI 52.4-75.7), and MEPS again showed higher discrimination than R2-ISS (C-index 0.729 vs. 0.647; bootstrap delta 0.082, 95% CI 0.041-0.127). MEPS provides a simple all-cause prognostic tool for elderly/NTE MM, complementing biologically oriented staging with routinely available host-related variables.
Insights
A new Myeloma Elderly Prognostic Score (MEPS) effectively predicts outcomes for elderly/non-transplant-eligible multiple myeloma patients. This score integrates host-related factors, offering improved prognostic discrimination over existing systems.
Area of Science:
- Hematology
- Oncology
- Geriatrics
Background:
- Established prognostic systems for multiple myeloma (MM) may not adequately address elderly or non-transplant-eligible (NTE) patients.
- Host-related factors like age, performance status, and renal function significantly impact overall survival (OS) in this population.
Purpose of the Study:
- To develop and validate the Myeloma Elderly Prognostic Score (MEPS), a pragmatic prognostic tool for elderly/NTE MM patients.
- To compare the prognostic discrimination of MEPS against the R2-ISS staging system.
Main Methods:
- Developed a four-factor MEPS integrating age (≥75 years), renal function (<40 eGFR or CrCl), ECOG performance status (≥2), and ultra-high-risk cytogenetics.
- Utilized registry data from 881 newly diagnosed NTE MM patients in Greece for development and validation in an independent Portuguese cohort (300 patients).
- Performed overall survival (OS) analyses and compared prognostic discrimination using C-indices.
Main Results:
- In the Greek cohort (n=878), median OS decreased with increasing MEPS score (96 months for score 0 to 15.3 months for score ≥3).
- Each MEPS category increase was associated with inferior OS (HR 1.74, p<0.001).
- MEPS demonstrated superior OS discrimination compared to R2-ISS in both Greek (C-index 0.655 vs. 0.602) and Portuguese (C-index 0.729 vs. 0.647) cohorts.
Conclusions:
- The MEPS is a simple, pragmatic prognostic tool for elderly/NTE MM patients.
- MEPS effectively integrates host-related variables to complement existing disease-centered staging systems.
- This score offers improved prognostic accuracy for all-cause outcomes in this vulnerable patient group.
