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@ARTICLE{Mai:285996,
      author       = {E. K. Mai and T. Hielscher$^*$ and U. Bertsch and H. J.
                      Salwender and S. Zweegman and M. S. Raab and M. Munder and
                      L. Pantani and K. Mancuso and P. Brossart and M. Beksac and
                      I. W. Blau and J. Dürig and B. Besemer and R. Fenk and P.
                      Reimer and B. van der Holt and M. Hänel and I. von Metzler
                      and U. Graeven and C. Müller-Tidow and M. Boccadoro and C.
                      Scheid and M. A. Dimopoulos and J. Hillengass and K. C.
                      Weisel and M. Cavo and P. Sonneveld and H. Goldschmidt},
      title        = {{P}redictors of early morbidity and mortality in newly
                      diagnosed multiple myeloma: data from five randomized,
                      controlled, phase {III} trials in 3700 patients.},
      journal      = {Leukemia},
      volume       = {38},
      number       = {3},
      issn         = {0887-6924},
      address      = {London},
      publisher    = {Springer Nature},
      reportid     = {DKFZ-2023-02577},
      pages        = {640-647},
      year         = {2024},
      note         = {2024 Mar;38(3):640-647},
      abstract     = {Early 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.},
      cin          = {C060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38062124},
      doi          = {10.1038/s41375-023-02105-6},
      url          = {https://inrepo02.dkfz.de/record/285996},
}