International prognostic index (IPI)--a critical comparison with five multiple myeloma staging systems in the group of 270 patients treated by conventional chemotherapy.

摘要: In the group of 270 patients with multiple myeloma (MM) treated during 1991-2004 by conventional chemotherapy, prognostic value and practical utility IPI (International Prognostic Index) was assessed compared five other actual staging systems. significance using curves overall survival (OS) according to Kaplan-Meier log rank test (p<0.05). Good Durie-Salmon (D-S) system confirmed (p<0.001). observed in simple systems based on measurement beta2-microglobulin albumin serum levels Bataille (p<0.001), SWOG (South West Oncology Group, p<0.001) Regardless a short 5-year duration study, scoring San Miguel enclosing apart from parameters also propidium iodide proliferation index (PC-PI) plasmocytes seems be promising very different characteristics Very good easy were examined Olomouc (OSS) thymidinekinase With regard detection stage 1, i. e. "low risk", not requiring an immediate initiation chemotherapy ("wait see" approach), most suitable D-S, (median OS 77, 76 77 months). To select cohort "high risk" patients, i.e. 3, unfavourable disease prognosis, advantageous OSS 5 6 months) and/or selecting 4, "worst prognosis", median 8 months. It found that did meet expectations for effective identification 3 20 nor distinction prognosis initial 25 months MM course at 2 vs. 3. The study indicates under conditions common clinical practice D-S is still useful, while application as simpler alternative assessment should verified further comparative studies. harmony progress cytogenetics molecular biology well prospective requirement individual target therapy, future stratification internal biological properties tissue microenvironment bone marrow, allowing addition continuous evaluation effect therapy.