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IMS 2024 | A new classification for identifying high-risk myeloma based on cytogenetic abnormalities
Jill Corre, PharmD, PhD, The Cancer University Institute of Toulouse Oncopole (IUCT), Toulouse, France, discusses the development of a new classification system for identifying high-risk multiple myeloma (HRMM) based on cytogenetic abnormalities. Dr Corre explains that traditional markers are no longer sufficient in the current treatment era. The new consensus, developed through an IMS workshop, now considers additional markers like TP53 mutation and a combination of other cytogenetic factors, providing a more accurate assessment of high-risk disease. This interview took place at the 21st International Myeloma Society (IMS) Annual Meeting, held in Rio de Janeiro, Brazil.
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Transcript
So, until now, myeloma patients were stratified according to the revised ISS system and high-risk cytogenetic in this system is del(17p), t(4;14) or t(14;16). Then we had the Revised-2 ISS where high-risk cytogenetic is del(17p), t(4;14) and 1q gain. But in this era of triplet and quadruplet treatments, we felt that these traditional cytogenetic factors capture no longer accurately the prognosis...
So, until now, myeloma patients were stratified according to the revised ISS system and high-risk cytogenetic in this system is del(17p), t(4;14) or t(14;16). Then we had the Revised-2 ISS where high-risk cytogenetic is del(17p), t(4;14) and 1q gain. But in this era of triplet and quadruplet treatments, we felt that these traditional cytogenetic factors capture no longer accurately the prognosis. So we decided with the IMS to have this workshop one year ago, more than one year ago in Barcelona. And it was the opportunity to define the consensus. So we had hot debates about this consensus, but at the end of the day we have the consensus. And this is the following statement: so a high risk patient now is a patient with a deletion 17P in more than 20% of plasma cells or a patient with a TP53 mutation or a patient with a bialellic deletion 1p32, or an association between intermediate factors which are the the so-called high-risk IGH translocation t(4;14), t(14;16), t(14;20) plus 1q or plus monoallelic deletion 1p32. In fact, these factors are not considered anymore as high-risk by themselves. They are often associated with each other and now this association is considered as high-risk.
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