Clinical application of the weighted cytogenetic scoring system in Multiple Myeloma

Methods Utility of the weighted cytogenetic scoring system (wCSS) was studied in 250 myeloma patients with complete data on high-risk FISH [t(4;14), t(14;6), del(1p32), amp(1q21) and del(17p)] and lactate dehydrogenase (LDH). Results All patients had bortezomib-based induction, with triplet induction in 88%. Sixty-four (26.2%) had ISS I, 75 (30.7%) stage II and 105 (43%) stage III MM. Fifty-two patients (21.2%) had t(4;14), 25 (10%) del(17p), 26 (10.4%) del(1p32) and 83 (66.8%) amp(1q21). Fifty-nine (23.9%) had wCSS=0, 144 (58.3%) wCSS>0 to ≤1 and 44 (17.8%) wCSS>1. Median survival were 168, 80 and 37 months for wCSS=0, >0 to ≤1, and wCSS>1 respectively (p=9.4 x 10-7). wCSS>1, of which 56.8% had del(17p), was not associated with gender, isotype, ISS III, high LDH or post-induction CR. Conclusion The adverse impact of wCSS>1was partially mitigated by ASCT. Therefore, wCSS is valid in our real-life cohort of myeloma uniform receiving a bortezomib-based triplet induction even without trisomy data.