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000285996 1001_ $$00000-0002-6226-1252$$aMai, Elias K$$b0
000285996 245__ $$aPredictors of early morbidity and mortality in newly diagnosed multiple myeloma: data from five randomized, controlled, phase III trials in 3700 patients.
000285996 260__ $$aLondon$$bSpringer Nature$$c2024
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000285996 500__ $$a2024 Mar;38(3):640-647
000285996 520__ $$aEarly morbidity and mortality affect patient outcomes in multiple myeloma. Thus, we dissected the incidence and causes of morbidity/mortality during induction therapy (IT) for newly diagnosed multiple myeloma (NDMM), and developed/validated a predictive risk score. We evaluated 3700 transplant-eligible NDMM patients treated in 2005-2020 with novel agent-based triplet/quadruplet IT. Primary endpoints were severe infections, death, or a combination of both. Patients were divided in a training (n = 1333) and three validation cohorts (n = 2367). During IT, 11.8%, 1.8%, and 12.5% of patients in the training cohort experienced severe infections, death, or both, respectively. Four major, baseline risk factors for severe infection/death were identified: low platelet count (<150/nL), ISS III, higher WHO performance status (>1), and age (>60 years). A risk score (1 risk factor=1 point) stratified patients in low (39.5%; 0 points), intermediate (41.9%; 1 point), and high (18.6%; ≥2 points) risk. The risk for severe infection/death increased from 7.7% vs. 11.5% vs. 23.3% in the low- vs. intermediate- vs. high-risk groups (p < 0.001). The risk score was independently validated in three trials incorporating quadruplet IT with an anti-CD38 antibody. Our analyses established a robust and easy-to-use score to identify NDMM patients at risk of severe infection/death, covering the latest quadruplet induction therapies. Trial registrations: HOVON-65/GMMG-HD4: EudraCT No. 2004-000944-26. GMMG-MM5: EudraCT No. 2010-019173-16. GMMG-HD6: NCT02495922. EMN02/HOVON-95: NCT01208766. GMMG-HD7: NCT03617731.
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000285996 7001_ $$0P:(DE-He78)743a4a82daab55306a2c88b9f6bf8c2f$$aHielscher, Thomas$$b1$$udkfz
000285996 7001_ $$aBertsch, Uta$$b2
000285996 7001_ $$00000-0001-7803-0814$$aSalwender, Hans J$$b3
000285996 7001_ $$aZweegman, Sonja$$b4
000285996 7001_ $$aRaab, Marc S$$b5
000285996 7001_ $$aMunder, Markus$$b6
000285996 7001_ $$aPantani, Lucia$$b7
000285996 7001_ $$00000-0002-1169-0129$$aMancuso, Katia$$b8
000285996 7001_ $$aBrossart, Peter$$b9
000285996 7001_ $$00000-0003-1797-8657$$aBeksac, Meral$$b10
000285996 7001_ $$aBlau, Igor W$$b11
000285996 7001_ $$aDürig, Jan$$b12
000285996 7001_ $$aBesemer, Britta$$b13
000285996 7001_ $$aFenk, Roland$$b14
000285996 7001_ $$aReimer, Peter$$b15
000285996 7001_ $$00000-0001-6414-2671$$avan der Holt, Bronno$$b16
000285996 7001_ $$aHänel, Mathias$$b17
000285996 7001_ $$avon Metzler, Ivana$$b18
000285996 7001_ $$00000-0001-6082-7710$$aGraeven, Ullrich$$b19
000285996 7001_ $$aMüller-Tidow, Carsten$$b20
000285996 7001_ $$00000-0001-8130-5209$$aBoccadoro, Mario$$b21
000285996 7001_ $$aScheid, Christof$$b22
000285996 7001_ $$00000-0001-8990-3254$$aDimopoulos, Meletios A$$b23
000285996 7001_ $$aHillengass, Jens$$b24
000285996 7001_ $$00000-0001-9422-6614$$aWeisel, Katja C$$b25
000285996 7001_ $$00000-0003-4514-3227$$aCavo, Michele$$b26
000285996 7001_ $$00000-0002-0808-2237$$aSonneveld, Pieter$$b27
000285996 7001_ $$aGoldschmidt, Hartmut$$b28
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