Evidence map›Paper›PMID 40195309›Full record

ArticleBlood cancer journal2025

A Real-World International Staging System (RW-ISS) for patients with newly diagnosed multiple myeloma.

Christian Brieghel, Tobias Schmidt Slørdahl, Morten Nørgaard Andersen, Agoston Gyula Szabo, Carsten Utoft Niemann, Sigrún Thorsteinsdóttir

Abstract read
In one paragraph

Article in Blood cancer journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. [European journal of nuclear medicine and molecular imaging · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Christian BrieghelDepartment of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.ORCID http://orcid.org/0000-0002-1816-8106
Tobias Schmidt SlørdahlDepartment of Hematology, St. Olavs Hospital, Trondheim, Norway.ORCID http://orcid.org/0000-0001-7488-4863
Morten Nørgaard AndersenDepartment of Hematology, Aarhus University Hospital, Aarhus, Denmark.
Agoston Gyula SzaboDepartment of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-9943-7007
Carsten Utoft NiemannDepartment of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.ORCID http://orcid.org/0000-0001-9880-5242
Sigrún ThorsteinsdóttirDepartment of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark. sigrun.thorsteinsdottir@regionh.dk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The revised international staging system (R-ISS) in multiple myeloma (MM) was recently updated as the second R-ISS (R2-ISS) and refined prognostication in clinical trial populations. By including 2929 Danish patients with MM and complete data on R2-ISS registered from 2005 through 2019, we validated the R2-ISS for overall survival (OS) in a population-based cohort; however, only partly among younger patients. We thus developed a real-world international staging system (RW-ISS) from a 75% training cohort. Feature selection and weighted scores of high-risk variables from a Cox regression model of OS included age >70 years (2 points), performance status (PS) > 1 (2 points), PS 1 (1 point), t(14;16) (1 point), ISS III (1 point), ISS II (0.5 points), high lactate dehydrogenase (0.5 points), and del(17p) (0.5 points). In the test set, patients with RW-ISS I (0-2.0 points, 38.2%), II (2.5-3.0 points, 19.8%), III (3.5-4.5 points, 27.1%), and IV (5.0-7.0 points, 15.0%) demonstrated a median OS of 9.5, 5.5, 3.4, and 1.1 years, respectively (P < 0.0001) and the C-index was superior for RW-ISS as compared to both R2-ISS and R-ISS (0.708 vs 0.604 vs 0.595, respectively). RW-ISS was in part externally validated. We thus recommend using RW-ISS in routine clinical care of NDMM.

Indexed as

Multiple MyelomaNeoplasm StagingAdultAgedAged, 80 and overDenmarkFemaleHumansMaleMiddle AgedPrognosis

Identifiers

PMID40195309
PMCPMC11977216

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.