Objective: To evaluate the prognostic value of Mayo MASS and R2-ISS staging systems in patients newly diagnosed with multiple myeloma (MM) . Methods: A total of 371 patients newly diagnosed with MM in Jiangsu Province Hospital were included in the study. Cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization (cIg-FISH) was performed to detect cytogenetic abnormality. Clinical characteristics were combined to analyze the disease stage and evaluate the prognosis. Results: There were 37 (10.0%), 264 (71.0%), and 70 (18.8%) patients in R-ISS stage Ⅰ, Ⅱ, and Ⅲ, respectively. The median progression-free survival (PFS) times were 37, 25, and 14 months (P<0.001). The median overall survival (OS) times were not reached (NR), 66, and 30 months (P<0.001). There were 71 (19.1%), 140 (37.7%), and 160 (43.2%) patients in Mayo MASS stages Ⅰ, Ⅱ, and Ⅲ, and the median PFS times periods were 43, 27, and 19 months (P<0.001), and the median OS times were NR, NR, 35 months, respectively (P<0.001). There were, 23 (6.2%), 69 (18.6%), 222 (59.8%), and 57 (15.4%) patients in R2-ISS stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. The median PFS times were 47, 31, 25, and 15 months (P=0.001), and the median OS times were NR, NR, 49, and 55 months, respectively (P<0.001) . Conclusion: Based on the R-ISS staging system, Mayo MASS, and R2-ISS prognostic staging system incorporated 1q21+, which allows a better stratification. However, the proportion of stage Ⅲ patients in Mayo MASS and R2-ISS staging systems is relatively high, which is considered related to the high incidence of 1q21+ and ISS Ⅲ in the Chinese population.
目的： 验证Mayo MASS、R2-ISS分期系统在初诊多发性骨髓瘤（MM）患者中的预后价值。 方法： 纳入南京医科大学第一附属医院收治的371例初诊MM患者，胞质轻链免疫荧光结合荧光原位杂交（cIg-FISH）检测患者的细胞遗传学特征，结合患者的临床资料分析其疾病分期并评估预后。 结果： R-ISS分期Ⅰ、Ⅱ、Ⅲ期患者分别有37例（10.0%）、264例（71.2%）和70例（18.8%），中位无进展生存（PFS）时间分别为37、31和14个月（P＝0.001），中位总生存（OS）时间分别为未达到（NR）、66个月和31个月（P<0.001）。Mayo MASS分期Ⅰ、Ⅱ、Ⅲ期患者分别有71例（19.1%）、140例（37.7%）和160例（43.2%），中位PFS时间分别为43、27和19个月（P<0.001），中位OS时间分别为NR、NR和35个月（P<0.001）。R2-ISS分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者分别有23例（6.2%）、69例（18.6%）、222例（59.8%）和57例（15.4%），中位PFS时间分别为47、31、25和15个月（P＝0.001），中位OS时间分别为NR、NR、49个月和55个月（P<0.001）。 结论： Mayo MASS和R2-ISS分期系统在R-ISS分期基础上纳入了1q21+，分期更完善，但两种分期系统下Ⅲ期患者比例偏高，考虑与中国MM患者1q21+发生率和ISS Ⅲ期比例较高相关。.
Keywords: Mayo staging system; Multiple myeloma; Prognosis; R2-ISS.