Abstract
Multiple myeloma is characterized by underlying clinical and biological heterogeneity, which translates to variable response to treatment and outcome. With the recent increase in treatment armamentarium and the projected further increase in approved therapeutic agents in the coming years, the issue of having some mechanism to dissect this heterogeneity and rationally apply treatment is coming to the fore. A number of robustly validated prognostic markers have been identified and the use of these markers in stratifying patients into different risk groups has been proposed. In this consensus statement, the International Myeloma Working Group propose well-defined and easily applicable risk categories based on current available information and suggests the use of this set of prognostic factors as gold standards in all clinical trials and form the basis of subsequent development of more complex prognostic system or better prognostic factors. At the same time, these risk categories serve as a framework to rationalize the use of therapies.
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Appendix
Appendix
International Myeloma Working Group
1. Niels Abildgaard, Syddansk Universitet, Odense, Denmark
2. Rafat Abonour, Indiana University School of Medicine, Indianapolis, Indiana, USA
3. Ray Alexanian, MD Anderson, Houston, Texas, USA
4. Melissa Alsina, H Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
5. Kenneth C Anderson, DFCI, Boston, Massachusetts, USA
6. Michel Attal, Purpan Hospital, Toulouse, France
7. Hervé Avet-Loiseau, Institute de Biologie, Nantes, France
8. Ashraf Badros, University of Maryland, Baltimore, Maryland, USA
9. Dalsu Baris, National Cancer Institute, Bethesda, Maryland, USA
10. Bart Barlogie, M.I.R.T. UAMS Little Rock, Arkanas, USA
11. Régis Bataille, Institute de Biologie, Nantes, France
12. Meral Beksaç, Ankara University, Ankara, Turkey
13. Andrew Belch, Cross Cancer Institute, Alberta, Canada
14. Dina Ben-Yehuda, Hadassah University Hospital, Hadassah, Israel
15. Bill Bensinger, Fred Hutchinson Cancer Center, Seattle, Washington, USA
16. P Leif Bergsagel, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA
17. Jenny Bird, Bristol Haematology and Oncology Center, Bristol, UK
18. Joan Bladé, Hospital Clinica, Barcelona, Spain
19. Mario Boccadoro, University of Torino, Torino, Italy
20. Jo Caers, Centre Hospitalier Universitaire de Liège, Liège, Belgium
21. Michele Cavo, Universita di Bologna, Bologna, Italy
22. Asher Chanan-Khan, Mayo Clinic, Jacksonville, Florida, USA
23. Wen Ming Chen, MM Research Center of Beijing, Beijing, China
24. Marta Chesi, Mayo Clinic Scottsdale, Scottsdale, Arizona, USA
25. Tony Child, Leeds General Hospital, Leeds, United Kingdom
26. James Chim, Department of Medicine, Queen Mary Hospital, Hong Kong
27. Wee-Joo Chng, National University Health System, Singapore
28. Ray Comenzo, Tufts Medical School, Boston, Massachusetts, USA
29. John Crowley, Cancer Research and Biostatistics, Seattle, Washington, USA
30. William Dalton, H Lee Moffitt, Tampa, Florida, USA
31. Faith Davies, Royal Marsden Hospital, London, England
32. Javier de la Rubia, Hospital Universitario La Fe, Valencia, Spain
33. Cármino de Souza, Univeridade de Campinas, Caminas, Brazil
34. Michel Delforge, University Hospital Gasthuisberg, Leuven, Belgium
35. Meletios Dimopoulos, University of Athens School of Medicine, Athens, Greece
36. Angela Dispenzieri, Mayo Clinic, Rochester, Minnesota, USA
37. Johannes Drach, University of Vienna, Vienna, Austria
38. Matthew Drake, Mayo Clinic Rochester, Rochester, Minnesota, USA
39. Brian G.M. Durie, Cedars-Sinai Samuel Oschin Cancer Center, Los Angeles, California, USA
40. Hermann Einsele, Universitätsklinik Würzburg, Würzburg, Germany
41. Theirry Facon, Centre Hospitalier Regional Universitaire de Lille, Lille, France
42. Dorotea Fantl, Socieded Argentinade Hematolgia, Buenos Aires, Argentina
43. Jean-Paul Fermand, Hopitaux de Paris, Paris, France
44. Carlos Fernández de Larrea, Hospital Clínic de Barcelona, Barcelona, Spain
45. Rafael Fonseca, Mayo Clinic Arizona, Scottsdale, Arizona, USA
46. Gösta Gahrton, Karolinska Institute for Medicine, Huddinge, Sweden
47. Ramón García-Sanz, University Hospital of Salamanca, Salamanca, Spain
48. Christina Gasparetto, Duke University Medical Center, Durham, North Carolina, USA
49. Morie Gertz, Mayo Clinic, Rochester, Minnesota, USA
50. Irene Ghobrial, Dana-Farber Cancer Institute, Boston, MA, USA
51. John Gibson, Royal Prince Alfred Hospital, Sydney, Australia
52. Peter Gimsing, University of Copenhagen, Copenhagen, Denmark
53. Sergio Giralt, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
54. Hartmut Goldschmidt, University Hospital Heidelberg, Heidelberg, Germany
55. Philip Greipp, Mayo Clinic, Rochester, Minnesota, USA
56. Roman Hajek, School of Medicine, University of Ostrava and University Hospital Ostrava, Ostrava, Czech Republic
57. Izhar Hardan, Tel Aviv University, Tel Aviv, Israel
58. Parameswaran Hari, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
59. Hiroyuki Hata, Kumamoto University Hospital, Kumamoto, Japan
60. Yutaka Hattori, Keio University School of Medicine, Tokyo, Japan
61. Tom Heffner, Emory University, Atlanta, Georgia, USA
62. Joy Ho, Royal Prince Alfred Hospital, Sydney, Australia
63. Antje Hoering, Cancer Research and Biostatistics, Seattle, WA, USA
64. Jian Hou, Shanghai Chang Zheng Hospital, Shanghai, China
65. Vania Hungria, Clinica San Germano, Sao Paolo, Brazil
66. Shinsuke Ida, Nagoya City University Medical School, Nagoya, Japan
67. Peter Jacobs, Constantiaberg Medi-Clinic, Plumstead, South Africa
68. Sundar Jagannath, Mt. Sinai Cancer Institute, New York, New York, USA
69. Hans Johnsen, Aalborg Hospital Science and Innovation Center, Aalborg, Denmark
70. Douglas Joshua, Royal Prince Alfred Hospital, Sydney, Australia
71. Artur Jurczyszyn, Department of Hematology University Hospital, Cracow, Poland
72. Jonathan Kaufman, Emory Clinic, Atlanta, Georgia, USA
73. Michio Kawano, Yamaguchi University, Ube, Japan
74. Eva Kovacs, Cancer Immunology Research-Life, Birsfelden, Switzerland
75. Amrita Krishnan, City of Hope, Duarte, California, USA
76. Sigurdur Kristinsson, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
77. Nicolaus Kröger, University Hospital Hamburg, Hamburg, Germany
78. Shaji Kumar, Department of Hematology, Mayo Clinic, Minnesota, USA 24
79. Robert A. Kyle, Department of Laboratory Med. and Pathology, Mayo Clinic, Minnesota, USA
80. Chara Kyriacou, Northwick Park Hospital, London, United Kingdom
81. Martha Lacy, Mayo Clinic Rochester, Rochester, Minnesota, USA
82. Juan José Lahuerta, Grupo Español di Mieloma, Hospital Universitario 12 de Octubre, Madrid, Spain
83. Ola Landgren, National Cancer Institute, Bethesda, Maryland, USA
84. Jacob Laubach, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
85. Garderet Laurent, Hôpital Saint Antoine, Paris, France
86. Fernando Leal da Costa, Instituto Portugues De Oncologia, Lisbon, Portugal
87. Jae Hoon Lee, Gachon University Gil Hospital, Incheon, Korea
88. Merav Leiba, Sheba Medical Center, Tel Hashomer, Israel
89. Xavier LeLeu, Hospital Huriez, CHRU Lille, France
90. Suzanne Lentzsch, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
91. Henk Lokhorst, University Medical CenterUtrecht, Utrecht, The Netherlands
92. Sagar Lonial, Emory University Medical School, Atlanta, Georgia, USA
93. Heinz Ludwig, Wilhelminenspital Der Stat Wien, Vienna, Austria
94. Anuj Mahindra, Dana-Farber Cancer Institute, Massachusetts General Hospital, Boston, MA, USA
95. Angelo Maiolino, Rua fonte da Saudade, Rio de Janeiro, Brazil
96. María Mateos, University of Salamanca, Salamanca, Spain
97. Amitabha Mazumder, NYU Comprehensive Cancer Center, New York, USA
98. Philip McCarthy, Roswell Park Cancer Center, Buffalo, New York, USA
99. Jayesh Mehta, Northwestern University, Chicago, Illinois, USA
100. Ulf-Henrik Mellqvist, Sahlgrenska University Hospital, Gothenburg, Sweden
101. GiamPaolo Merlini, University of Pavia, Pavia, Italy
102. Joseph Mikhael, Mayo Clinic Arizona, Scottsdale, Arizona, USA
103. Philippe Moreau, University Hospital, Nantes, France
104. Gareth Morgan, Royal Marsden Hospital, London, England
105. Nikhil Munshi, Diane Farber Cancer Institute, Boston, Massachusetts, USA
106. Hareth Nahi, Karolinska University Hospital, Stockholm, Sweden
107. Ruben Niesvizky, Weill Cornell Medical College, New York, USA
108. Amara Nouel, Hospital Rutz y Paez, Bolivar, Venezuela
109. Yana Novis, Hospital Sírio Libanês, Bela Vista, Brazil
110. Enrique Ocio, Salamanca, Spain
111. Robert Orlowski, MD Anderson Cancer Center, Houston, Texas, USA
112. Antonio Palumbo, Cathedra Ematologia, Torino, Italy
113. Santiago Pavlovsky, Fundaleu, Buenos Aires, Argentina
114. Linda Pilarski, University of Alberta, Alberta, Canada
115. Raymond Powles, Leukemia & Myeloma, Wimbledon, England
116. Noopur Raje, Massachusetts General Hospital, Boston, Massachusetts, USA 25
117. S. Vincent Rajkumar, Mayo Clinic, Rochester, Minnesota, USA
118. Donna Reece, Princess Margaret Hospital, Toronto, Canada
119. Tony Reiman, Saint John Regional Hospital, Saint John, New Brunswick, Canada
120. Paul G. Richardson, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
121. Angelina Rodríguez Morales, Bonco Metro Politano de Sangre, Caracas, Venezuela
122. Kenneth R. Romeril, Wellington Hospital, Wellington, New Zealand
123. David Roodman, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania USA
124. Laura Rosiñol, Hospital Clinic, Barcelona, Spain
125. Stephen Russell, Mayo Clinic, Rochester, Minnesota, USA
126. Jesús San Miguel, University of Salamanca, Salamanca, Spain
127. Rik Schots, Universitair Ziekenhuis Brussel, Brussels, Belgium
128. Sabina Sevcikova, Masaryk University, Brno, Czech Republic
129. Orhan Sezer, Universität Hamburg, Hamburg, Germany
130. Jatin J. Shah, MD Anderson Cancer Institute, Houston, Texas, USA
131. John Shaughnessy, M.I.R.T. UAMS, Little Rock, Arkansas, USA
132. Kazuyuki Shimizu, Nagoya City Midori General Hospital, Nagoya, Japan
133. Chaim Shustik, McGill University, Montreal, Canada
134. David Siegel, Hackensack, Cancer Center, Hackensack, New Jersey, USA
135. Seema Singhal, Northwestern University, Chicago, Illinois, USA
136. Pieter Sonneveld, Erasmus MC, Rotterdam, The Netherlands
137. Andrew Spencer, The Alfred Hospital, Melbourne, Australia
138. Edward Stadtmauer, University of Pennsylvania, Philadelphia, Pennsylvania, USA
139. Keith Stewart, Mayo Clinic Arizona, Scottsdale, Arizona, USA
140. Evangelos Terpos, University of Athens School of Medicine, Athens, Greece
141. Patrizia Tosi, Italian Cooperative Group, Istituto di Ematologia Seragnoli, Bologna, Italy
142. Guido Tricot, Huntsman Cancer Institute, Salt Lake City, Utah, USA
143. Ingemar Turesson, SKANE University Hospital, Malmo, Sweden
144. Saad Usmani, M.I.R.T UAMS, Little Rock, Arkansas, USA
145. Ben Van Camp, Vrije Universiteit Brussels, Brussels, Belgium
146. Brian Van Ness, University of Minnesota, Minneapolis, Minnesota, USA
147. Ivan Van Riet, Brussels Vrija University, Brussels, Belgium
148. Isabelle Vande Broek, Vrije Universiteit Brussels, Brussels, Belgium
149. Karin Vanderkerken, Vrije University Brussels VUB, Brussels, Belgium
150. Robert Vescio, Cedars-Sinai Cancer Center, Los Angeles, California, USA
151. David Vesole, Hackensack Cancer Center, Hackensack, New Jersey, USA
152. Peter Voorhees, University of North Carolina, Chapel Hill, North Carolina, USA
153. Anders Waage, University Hospital, Trondheim, Norway NSMG
154. Michael Wang, MD Anderson, Houston, Texas, USA 26
155. Donna Weber, MD Anderson, Houston, Texas, USA
156. Jan Westin, Sahlgrenska University Hospital, Gothenburg, Sweden
157. Keith Wheatley, University of Birmingham, Birmingham, United Kingdom
158. Elena Zamagni, University of Bologna, Bologna, Italy
159. Jeffrey Zonder, Karmanos Cancer Institute, Detroit, Michigan, USA
160. Sonja Zweegman, VU University Medical Center, Amsterdam, The Netherlands
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Chng, W., Dispenzieri, A., Chim, CS. et al. IMWG consensus on risk stratification in multiple myeloma. Leukemia 28, 269–277 (2014). https://doi.org/10.1038/leu.2013.247
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DOI: https://doi.org/10.1038/leu.2013.247
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