Investigators have shown that the EMC92-International Staging System (ISS) is a robust novel prognostic tool compared with current markers, according to an online article published ahead of print in Blood.1

Patients with multiple myeloma require reliable prognostic and predictive scoring systems. Currently, clinical and biological risk factors are used independently.

In this study, ISS, FISH markers, and gene expression (GEP) classifiers were combined in order to identify novel risk classifications in a discovery/validation setting. Several datasets were used on 4,750 patients.

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Twenty risk markers were evaluated including t(4; 14) and deletion of 17p (FISH), EMC92, GEP classifiers, and ISS.

The novel risk classifications showed that ISS is a valuable partner to FISH and, when ranked against all novel and existing risk classifications, the EMC92-ISS combination is the strongest predictor of overall survival.

Median survival was 24 months for the highest risk group, 47 and 61 months for the intermediate risk group, and a median was not reached after 96 months for the lowest risk group.


  1. Kuiper R, van Duin M, van Vilet M, et al. Prediction of high- and low-risk multiple myeloma based on gene expression and the International Staging System [published online ahead of print September 1, 2015]. Blood. doi: 10.1182/blood-2015-05-644039.