Outcome prediction in newly diagnosed multiple myeloma: a comparison meta-analysis between ISS and R-ISS in 8536 patients
Notice bibliographique
Résumé
Prognostic stratification for multiple myeloma (MM) has changed dramatically in the last two decades. Various groups worldwide, as well as international guidelines, recommends the treatment orientation according to risk. Since 2015, the international MM working group (IMWG) recommends complementing the ISS scale with cytogenetic studies in both eligible and ineligible patients for autologous bone marrow transplantation; however, many countries do not have the technology to carry out these studies properly. There is uncertainty about whether the R-ISS (classification Revised International Staging System) offers a better risk stratification over the ISS, in patients younger than 65 with newly diagnosed MM. Objective Determine whether the application of the R-ISS staging system compared to ISS better discriminates risk and establishes better prognostic discrimination in terms of survival in patients younger than 65 years with a new diagnosis of MM. Search methods A systematic search was made for articles published between 2010-2020 in English and Spanish in Pubmed, Embase, Lilacs. DeCS and MeSH terms were used as well as free text. The search for studies was carried out by two independent reviewers. The study’s Prospero registration number CRD42021230257 Eligibility criteria Randomized and non-randomized clinical trials and observational studies compared the ISS and R-ISS scales in terms of survival in patients aged 65 years or less, of both sexes, with a new MM diagnosis. Methods of evaluation and synthesis of data Study selection was carried out by two independent reviewers; Discrepancies were resolved by consensus by performing data extraction using a form developed according to the template proposed in the Cochrane Collaboration Manual. Risk of bias was assessed using the Newcastle-Ottawa Scale for cohort studies. A descriptive analysis of the characteristics of the included studies and their results was carried out. Results A total of 10 studies met the inclusion criteria; all were retrospective cohort and included a total of 8. 536 patients. A meta-analysis with a random-effects model was performed with 5 studies for the overall survival outcome, finding a combined HR of 6. 26 (4.08 - 9.61) for RISS3 vs. 2.92 (1.48 - 5.73) for ISS-3. For the outcome of progression-free survival, a combined HR of 2.84 (1.86 - 4.33) vs. HR 1.89 (1.53 - 2.33) of ISS-3 was found. Interpretation The R- ISS classification has a better discriminating power for high-risk groups than standard risk; however, with the current evidence, it is impossible to ensure that the discriminatory capacity is significant in the survival rates and the prognosis of patients with low or intermediate risk. Funding This study has no funding source.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».