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IMWG consensus on risk stratification in multiple myeloma


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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Correspondence to W J Chng.

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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).

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