Blood cancers

MRP a valuable risk assessment tool for newly diagnosed multiple myeloma

A clinical prediction model for myeloma has been shown to be “a robust and valuable tool” in a real-world population of Danish patients.

The Myeloma Risk Profile (MRP) was developed by the UK Myeloma Research Alliance in 2019 to help aid decision making in patients who are ineligible for stem-cell transplantation.

Based on data from two prospective clinical trial cohorts, the MRP was designed to be easier to use in practice than other more complicated MM risk scores.

Now researchers have tested its use in a ‘real-world’ population of 1,377 patients and found it divides patients into “truly different risk groups”.

Reporting their findings in the British Journal of Haematology, the researchers tested the score using data from the Danish National Multiple Myeloma Registry on a group of newly diagnosed transplant-ineligible patients with multiple myeloma aged 65 years or older.

The MRP score categorised 28.5% of the patients as low risk, 25.1% as medium risk and 46.4% as high risk.

And further analysis of the data showed clear differences in prognosis between the groups.

In the low-risk group the researchers found median overall survival of 55.0 months compared to a median survival of only 13.9 months in those categorised as high risk and 35.9 months in the medium-risk group.

The team also compared the risk model over time to take into account changes in treatment patterns but found no difference in how well the risk score performed.

There were also significant differences between the three groups in response to first-line therapy with early death and primary refractory disease highest in the high-risk group and clear differences in median time on treatment.

The Danish team concluded that “the MRP score is a robust and valuable risk assessment tool” for newly diagnosed patients with multiple myeloma over the age of 65 years and ineligible for a stem-call transplant and called for prospective trials to test different treatment strategies based on the risk profile.

They added: “An important advantage of the MRP score is that it is calculated from easily accessible parameters that are part of the routine diagnostic work-up of myeloma patients.”

Professor Gordon Cook, professor of haematology at the University of Leeds and Chair of the UK Myeloma Research Alliance said real world validation of the MRP is essential before any adoption into clinical practice, and there are plans for more work on it.

“This is only the start of testing it as a possible prognostic biomarker. Much more is needed before we even get to testing it as predictive biomarker,” he added.

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