IMS/IMWG consensus genomic staging for high-risk MM: A cohort study in NDMM

Results from a single-center cohort study evaluating the International Myeloma Society (IMS)/International Myeloma Working Group (IMWG) consensus genomic staging (CGS) criteria for high-risk multiple myeloma (MM) in 1,209 patients with newly diagnosed multiple myeloma (NDMM), treated between 2010 and 2024, were published in HemaSphere by Kastritis et al. 

Key data: Based on IMS/IMWG CGS criteria, 25.2% of patients were classified as high-risk. At a median follow-up of 5.25 years, median overall survival (OS) was 44 months in patients with high-risk MM vs 93 months in those with standard-risk MM (hazard ratio [HR], 1.81; 95% confidence interval [CI], 1.51–2.20; p < 0.001), and median progression-free survival (PFS) was 21.3 months vs 36 months, respectively (HR, 1.64; 95% CI, 1.40–1.90; p < 0.001). Among patients with high-risk MM, 4.4% of the overall cohort had ≥2 high-risk features; median OS was 25 months in patients with ≥2 high-risk features vs 52 months in those with 1 high-risk feature (HR, 1.90; 95% CI, 1.30–2.80; p = 0.001), and median PFS was 15.8 months vs 23.8 months, respectively (p = 0.003). Compared with standard-risk MM, patients with ≥2 high-risk features had a higher risk of death (HR, 3.10; 95% CI, 2.20–4.20; p < 0.001). 

Key learning: The IMS/IMWG CGS identified high- and ultra-high-risk populations among patients with NDMM, with different survival outcomes, supporting further use of the CGS for risk stratification in clinical research and practice.