@article {7525,
	title = {Revised international staging system for multiple myeloma: A report from international myeloma working group},
	journal = {Journal of Clinical Oncology},
	volume = {33},
	year = {2015},
	note = {Cited By :73Export Date: 21 February 2017},
	month = {2015},
	pages = {2863 - 2869},
	abstract = {Purpose: The clinical outcome of multiple myeloma (MM) is heterogeneous. A simple and reliable tool is needed to stratify patients with MM. We combined the International Staging System (ISS) with chromosomal abnormalities (CA) detected by interphase fluorescent in situ hybridization after CD138 plasma cell purification and serum lactate dehydrogenase (LDH) to evaluate their prognostic value in newly diagnosed MM (NDMM). Patients and Methods: Clinical and laboratory data from 4,445 patients with NDMM enrolled onto 11 international trials were pooled together. The K-adaptive partitioning algorithm was used to define the most appropriate subgroups with homogeneous survival. Results: ISS, CA, and LDH data were simultaneously available in 3,060 of 4,445 patients. We defined the following three groups: revised ISS (R-ISS) I (n = 871), including ISS stage I (serum β2-microglobulin level \&lt; 3.5 mg/L and serum albumin level >= 3.5 g/dL), no high-risk CA [del(17p) and/or t(4;14) and/or t(14;16)], and normal LDH level (less than the upper limit of normal range); R-ISS III (n = 295), including ISS stage III (serum β2-microglobulin level \&gt; 5.5 mg/L) and high-risk CA or high LDH level; and R-ISS II (n = 1,894), including all the other possible combinations. At a median follow-up of 46 months, the 5-year OS rate was 82\% in the R-ISS I, 62\% in the R-ISS II, and 40\% in the R-ISS III groups; the 5-year PFS rates were 55\%, 36\%, and 24\%, respectively. Conclusion: The R-ISS is a simple and powerful prognostic staging system, and we recommend its use in future clinical studies to stratify patients with NDMM effectively with respect to the relative risk to their survival. {\textcopyright} 2015 American Society of Clinical Oncology. All rights reserved.},
	url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84951020021\&doi=10.1200\%2fJCO.2015.61.2267\&partnerID=40\&md5=c542a5d3d3ecd7e8b2b883500f82d358},
	author = {Palumbo, A. and Avet-Loiseau, H. and Oliva, S. and Lokhorst, H.M. and Goldschmidt, H. and Rosinol, L. and Richardson, P. and Caltagirone, S. and Lahuerta, J.J. and Facon, T. and Bringhen, S. and Gay, F. and Attal, M. and Passera, R. and Spencer, A. and Offidani, M. and Kumar, S. and Musto, P. and Lonial, S. and Petrucci, M.T. and Orlowski, R.Z. and Zamagni, E. and Morgan, G. and Dimopoulos, M.A. and Durie, B.G.M. and Anderson, K.C. and Sonneveld, P. and Miguel, J.S. and Cavo, M. and Rajkumar, S.V. and Moreau, P.}
}
