PROGNOSTIC VALUE OF CLINICAL, LABORATORY, AND HISTOLOGICAL CHARACTERISTICS IN MULTIPLE-MYELOMA - IMPROVED DEFINITION OF RISK GROUPS

Follow-up data of 320 multiple myeloma (MM) patients entering the Germ an Myeloma Treatment Group (GMTG) trial MM01 were analysed for factors predicting overall (OAS) and tumour related survival (TRS). Response to primary induction chemotherapy was relevant for prognosis if a limi t of 25% tumour cell mass (TCM) reduction was used to separate respond ers from non-responders. Furthermore, TCM, histological grading of mye loma cells, degree of bone marrow infiltration, haemoglobin, platelet counts, calcium, creatinine, albumin, beta2M, and Bence Jones proteinu ria correlated to both OAS and TRS. Age was relevant for OAS only. The multivariate analysis revealed histological grading, TCM and platelet s as the most reliable prognostic factors. Based on these data the Dur ie/Salmon classification could be improved by defining poor prognosis patients (50% TRS: 16 months) characterised by pretreatment platelets of less-than-or-equal-to 150.000 and/or poorly differentiated myeloma cell morphology. Patients lacking both risk factors displayed 50% surv ival times of 46 months in stage III and 88 months in stage II.