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MD NewslineReal-World Outcomes in Newly Diagnosed Multiple Myeloma Based on iFISH

A retrospective analysis reveals high-risk fluorescent in situ hybridization (iFISH) markers as significant prognostic tools for real-world survival outcomes in newly diagnosed multiple myeloma (NDMM)

A retrospective study published in Apollo Medicine evaluates the prognostic value of interphase fluorescent in situ hybridization (iFISH) markers in newly diagnosed multiple myeloma (NDMM) patients receiving proteasome inhibitors. The study highlights the practical implications of iFISH in stratifying patients based on survival outcomes, revealing substantial differences between high-risk and standard-risk cohorts.

Key Points:

  • Study Design: Retrospective analysis of NDMM patients receiving proteasome inhibitors, focusing on iFISH-based survival outcomes.
  • Patient Demographics: The study included 25 adults with NDMM, median age of 60 (range 34-87), with disease stages I (5 patients), II, and III (8 patients).
  • High-Risk iFISH Markers: Detected in 12 patients, including cyclin-dependent kinases regulatory subunit 1B (CKS1B) in 9 patients, fibroblast growth factor receptor 3 (IGH-FGFR3) in 2 patients, and del17p mutation in 1 patient.
  • Treatment Regimens:
    • 20 patients received RVd (bortezomib, lenalidomide, dexamethasone).
    • 2 patients received CyBord (cyclophosphamide, bortezomib, dexamethasone).
    • 1 patient received KRd (carfilzomib, lenalidomide, dexamethasone).
    • 2 patients received DRVd (daratumumab, RVd).
  • Toxicity Observations:
    • Grade II thrombocytopenia in 3 patients and grade II anemia and neutropenia in 4 patients (associated with lenalidomide) during RVd treatment.
    • Grade III sensorimotor peripheral neuropathy in one patient (associated with bortezomib) after four RVd cycles.
  • Treatment Response: Overall treatment response to four induction cycles was approximately 92%.
  • Survival Outcomes:
    • 2.5-year overall survival: 55.6% in high-risk vs. 100% in standard-risk cohorts (p = 0.01).
    • 2.5-year event-free survival: 34.2 ± 16.5% in high-risk vs. 77.8 ± 13.8% in standard-risk cohorts.
    • Five patient deaths, with three attributed to severe sepsis.

“High-risk iFISH markers in NDMM patients reveal substantial differences in survival outcomes, underscoring the importance of precise prognostic assessment.”

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