In 2015, the U.S. Food and Drug Administration (FDA) approved 4 new therapies for the treatment of multiple myeloma. In addition to the number of novel therapies under development for multiple myeloma, researchers are beginning to understand how the disease works, which will increase the number of prognostic markers that can be used to provide information about outcome, according to a review published in the British Journal of Haematology.1
Prognostic markers for myeloma now include a range of features such as patient fitness, disease biology, genetic lesions, radiological features, and depth of response.
“Based on the available prognostic markers, we use the information to counsel our patients regarding their prognosis and treatment options,” Henry Fung, MD, FRCPE, vice chair of hematology at the Fox Chase Cancer Center, and director of the Fox Chase Cancer Center-Temple University Hospital Bone Marrow Transplant Program in Philadelphia Pennsylvania, told Cancer Therapy Advisor.
Known Prognostic Markers
Age is a strong prognostic factor for patients with myeloma, but ongoing research shows that it does not directly affect outcomes. Age may, however, affect the intensity of treatment selected for a patient’s disease. For example, fitness for stem cell transplantation may be more important than age, according to the review.2
A patient’s disease biology, including proliferation rate, can also affect prognosis. One study showed that a high proliferation index was associated with a longer overall survival, compared with a proliferation rate of less than 1% S-phase plasma cells.3
Genetic lesions present in the myeloma can also affect prognosis. Multiple studies show that translocation (4;14) confers poor prognosis.4,5,6
As more of these prognostic markers are discovered, researchers continue to study how they affect disease outcomes.