Prognostic evaluation and staging optimization of the Mayo Additive Staging System (MASS) in real world for newly diagnosed multiple myeloma patients

Figures & data

Table 1. Clinical characteristics of 307 newly diagnosed MM patients.

Clinical character		N(%)
Age	<65	228 (74.3)
	≥65	79 (25.7)
Gender	male	172 (56.0)
	female	135 (44.0)
ISS staging	I	82 (26.7)
	II	108 (35.2)
	III	117 (38.1)
R-ISS staging	I	64 (20.8)
	II	174 (56.7)
	III	69 (22.5)
IgH translocations	t(4,14)	27 (8.8)
	t(14,20)	0(0)
	t(14,16)	1 (0.3)
del (17p)		41 (13.4)
1q gain/amplification		152 (49.5)
Lactate dehydrogenase(LDH)(U/L)	≤245	59 (19.2)
	>245	248 (80.8)
Renal function	normal	86 (28.0)
	damaged	221 (72.0)
Bone	normal	28(9.1)
	damaged	279(90.9)
Transplant		140 (45.6)
First-line Treatment	PI + IMiDs	76(24.8)
	PI + conventional chemotherapy	197(61.2)
	ImiDs + conventional chemotherapy	34(11.1)

Table 2. Clinical characteristics of 307 newly diagnosed MM patients in different MASS staging.

Clinical character		MASS I (n = 93)	MASS II (n = 91)	MASS III (n = 123)	P
Age	<65	76	66	86	0.131
	≥65	17	25	37
Gender	male	51	56	65	0.432
	female	42	35	58
ISS staging	I	50	25	7	0.000
	II	43	42	24
	III	0	24	93
mSMART3.0	Standard-risk	93	24	0	0.000
	High-risk	0	67	123
R-ISS staging	I	49	14	0	0.000
	II	44	71	60
	III	0	6	63
IgH translocations	t(4,14)	0	3	24	0.000
	t(14,20)	0	0	0
	t(14,16)	0	0	1
Hemoglobin (g/L)		111 (42-169)	92 (38-156)	75 (39-145)	0.000
Blood calcium (mmol/L)		2.22 (1.6-2.95)	2.2 (1.81-2.94)	2.25 (1.61-3.71)	0.159
β2 microglobulin (ug/L)		2.55 (0.8-9.19)	3.78 (0.2-43)	7.21 (1.52-50)	0.000
del (17p)		0	4	37	0.001
1q gain/amplification		0	54	98	0.001
LDH(U/L)	≤245	93	85	70	0.001
	>245	0	6	53
Renal function	normal	85	68	68	0.000
	damaged	8	23	55
Bone	normal	9	10	9	0.637
	damaged	84	81	114

Figure 1. A: Survival curve of MM patients with stage I, II and III based on R-ISS; B: Survival curve of MM patients in mSMART3.0 low and high risk groups; C: Survival curve of MM patients in MASS stage I, II and III.

Figure 2. A: Survival curve of patients in PI + IMiDs group with different MASS risk stratification; B: Survival curve of patients in PI + conventional chemotherapy group with different MASS risk stratification; C: Survival curve of patients in IMiDs + conventional chemotherapy group with different MASS risk stratification.

Figure 3. A: Survival curve of patients in senior age group with different MASS risk stratification; B: Survival curve of patients in younger age group with different MASS risk stratification; C: Survival curve of patients in transplant group with different MASS risk stratification; D: Survival curve of patients in non-transplant group with different MASS risk stratification.

Figure 4. A: Survival curve of patients in normal renal function group with different MASS risk stratification; B: Survival curve of patients in injured renal function group with different MASS risk stratification.

Figure 5. A: Survival curves of patients who are suitable for transplantation but do not undergo transplantation based on MASS risk stratification; B: Survival curve of patients with bone destruction based on MASS.

Figure 6. A: Survival curve of MM patients between MM patients with complex karyotype and mSMART single-hit; B: Survival curve of MM patients between MM patients with complex karyotype and mSMART double-hit; C: Survival curve of MM patients between MM patients with complex karyotype and MASSIII.

Figure 7. Survive curves of patients with MASS score 2、3 and 4 points.

Figure 8. A: Survival curve of patients in mSMART3.0 standard-risk group with different MASS risk stratification; B: Survival curve of patients in mSMART3.0 high-risk group with different MASS risk stratification; C: Survival curve of patients in R-ISS stsge II group with different MASS risk stratification.

Figure 9. Stage migration between mSMART3.0 and MASS and R-ISS and MASS. The distribution and migration of patients between disease stages using R-ISS, mSMART3.0 and MASS risk stratification systems.

Data availability statement

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.