Studies evaluating scoring systems to identify the risk of early relapse
| Score . | Variables . | Risk groups (sum) . | Clinical outcomes . |
|---|---|---|---|
| CIBMTR scoring system28 | • High-risk cytogeneticsa: +4 points • Pre-ASCT BMPCs ≥10%: +4 points • Albumin at diagnosis ≤3,5 g/dL: +2 points • Standard-risk cytogenetic: +1 point • No cytogenetic abnormality, BMPCs <10% at ASCT, and albumin ≥3.5 g/dL at diagnosis: +0 point | • Low risk (0-3) • Intermediate risk (4-8) • High risk (9-10) | 3-year PFS: 58% vs 49% vs 31% (P < .001) 3-year OS: 88% vs 81% vs 64% (P < .001) |
| S-ERMM(18) score29 | • LDH > ULN: +5 points • Presence of t(4;14): +5 points • Presence of del(17p): +3 points • Abnormal albumin: +3 points • BMPCs >60%: +3 points • FLC λ: +2 points | • Low risk (≤5) • Intermediate risk (6-10) • High risk (≥11) | Median OS: NR vs 59.5 mo vs 31.5 mo (P < .001) Median PFS2: 62.3 mo vs 40 vs 19.8 mo (P < .001) |
| DS-ERMM score29 | • S-ERMM score (0-21 points) • Achievement of at least VGPR: −4 points | • Low risk (≤0) • Intermediate risk (1-5) • High risk (≥6) | Median OS: NR vs NR vs 57.3 mo (P < .001) Median PFS2: NR vs 53.8 mo vs 40.2 mo (P < .001) |
| EBMT scoring system30 | • Disease status at ASCT: 0-3 points CR/VGPR: +0 point PR/SD/MR: +1 point Rel/prog: +3 points • ISS: ISS I: +0 point ISS II: +1 point ISS III: +2 points • Age (years): −1 to −3 points ≤55: −1 point; 55-75: −2 points ≥75: −3 points | Score −2 Score −1 Score 0 Score 1 Score 2 | 12-mo PFS2, score −2 vs score 2: 91% vs 65% |
| EBMT scoring system31 | • Disease status at auto-HSCT: 0-4 points CR/VGPR: +0 point PR: +1 point PR/SD/MR: +2 points Rel/prog: +3 points- ISS: 0-2 points ISS I: +0 point ISS II: +1 point ISS III: +2 points • Karnofsky performance status: +1 point | • Risk score 0 (0) • Risk score 1 (1) • Risk score 2 (2) • Risk score 3 (3) • Risk score 4 (≥4) | 12-mo PFS, risk score 0 vs risk score 4: 91.7% vs 57.1% |
| Score . | Variables . | Risk groups (sum) . | Clinical outcomes . |
|---|---|---|---|
| CIBMTR scoring system28 | • High-risk cytogeneticsa: +4 points • Pre-ASCT BMPCs ≥10%: +4 points • Albumin at diagnosis ≤3,5 g/dL: +2 points • Standard-risk cytogenetic: +1 point • No cytogenetic abnormality, BMPCs <10% at ASCT, and albumin ≥3.5 g/dL at diagnosis: +0 point | • Low risk (0-3) • Intermediate risk (4-8) • High risk (9-10) | 3-year PFS: 58% vs 49% vs 31% (P < .001) 3-year OS: 88% vs 81% vs 64% (P < .001) |
| S-ERMM(18) score29 | • LDH > ULN: +5 points • Presence of t(4;14): +5 points • Presence of del(17p): +3 points • Abnormal albumin: +3 points • BMPCs >60%: +3 points • FLC λ: +2 points | • Low risk (≤5) • Intermediate risk (6-10) • High risk (≥11) | Median OS: NR vs 59.5 mo vs 31.5 mo (P < .001) Median PFS2: 62.3 mo vs 40 vs 19.8 mo (P < .001) |
| DS-ERMM score29 | • S-ERMM score (0-21 points) • Achievement of at least VGPR: −4 points | • Low risk (≤0) • Intermediate risk (1-5) • High risk (≥6) | Median OS: NR vs NR vs 57.3 mo (P < .001) Median PFS2: NR vs 53.8 mo vs 40.2 mo (P < .001) |
| EBMT scoring system30 | • Disease status at ASCT: 0-3 points CR/VGPR: +0 point PR/SD/MR: +1 point Rel/prog: +3 points • ISS: ISS I: +0 point ISS II: +1 point ISS III: +2 points • Age (years): −1 to −3 points ≤55: −1 point; 55-75: −2 points ≥75: −3 points | Score −2 Score −1 Score 0 Score 1 Score 2 | 12-mo PFS2, score −2 vs score 2: 91% vs 65% |
| EBMT scoring system31 | • Disease status at auto-HSCT: 0-4 points CR/VGPR: +0 point PR: +1 point PR/SD/MR: +2 points Rel/prog: +3 points- ISS: 0-2 points ISS I: +0 point ISS II: +1 point ISS III: +2 points • Karnofsky performance status: +1 point | • Risk score 0 (0) • Risk score 1 (1) • Risk score 2 (2) • Risk score 3 (3) • Risk score 4 (≥4) | 12-mo PFS, risk score 0 vs risk score 4: 91.7% vs 57.1% |
t(4;14),t(14;16),t(14;20), del(13q/monosomy 13 on karyotype), del(17p),1q gain,1p del.
BMPCs, bone marrow plasma cells; CIBMTR, Center for Blood and Marrow Transplant Research; CR, complete response; DS-ERMM, dynamic simplified early relapse in multiple myeloma; EBMT, European Society for Blood and Marrow Transplantation; FLC, free light chain; MMRF, Multiple Myeloma Research Foundation; MR, minimal response; NR, not reached; PFS2, progression-free survival-2; Rel/prog, relapse/progression; SD, stable disease; S-ERMM18, simplified early relapse in multiple myeloma (18 months); ULN, upper limit of normal.