ArticleFrontiers in oncology2026
Multiple myeloma in the real-world practice: clinical and prognostic indeces - single center experience.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The Second Revision of the International Staging System (R2-ISS) is an prognostic model established in newly diagnosed multiple myeloma (NDMM) patients as a marker of disease-related biological risk. Still, the course of disease is influenced by patient-related factors as well. The International Myeloma Working Group (IMWG) frailty score provides a standardized assessment of patient fitness and may complement biological risk stratification. The aim of study was to analyze prognostic significance of R2-ISS scoring system and IMWG frailty status in NDMM patients (pts) within RWE settings of the routine clinical practice. Methods: Analyzed group included 371 NDMM patients (pts, 184 males/187 females, median age 62.9 years, range 36-88) diagnosed between 2018 and 2025. Patients were stratified at the time of diagnosis according to the ISS, R-ISS, R2-ISS, and the original IMWG frailty score. Treatment response and follow-up were assessed according to the IMWG response criteria and EHA-EMN recommendations. Differences in progression-free survival (PFS) and overall survival (OS) were assessed using the Kaplan-Meier method and log-rank test. Independent OS predictors were identified using the Cox proportional hazards regression model. Results: Treatment response (≥PR) was achieved in 275 of 340 evaluable patients (80.9%). Increasing R2-ISS stage was associated with a lower probability of achieving treatment response (p=0.027), while frailty independently correlated with inferior response rates (p<0.001). Both PFS (p < 0.001) and OS (p < 0.001) was significantly shorter in patients with higher R2-ISS stages. In accordance to the IMWG frailty score, fit patients had significantly durable PFS (p<0.001) and the OS (p <0.001). Importantly, the composite classification integrating R2-ISS and IMWG frailty score provided additional discrimination of OS (p<0.001). Multivariate model for OS pointed out most significant impact of frailty status (p<0.001), followed by treatment response categories (p<0.001), and R2-ISS (p=0.009). Conclusion: R2-ISS and IMWG frailty score provide complementary prognostic information in NDMM. Their combined assessment improves risk stratification beyond disease-related factors alone and may facilitate more individualized treatment planning in the routine clinical practice.
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