Patient Power: Are Myeloma Experts Redefining "High Risk"?

Myeloma expert Dr. Tanya Wildes of the Washington University School of Medicine spoke at the recent ASCO (American Society of Clinical Oncology) conference in Chicago. Her topic was addressing a new definition of "high-risk" for older multiple myeloma patients.

Traditionally, standard-risk and higher-risk are defined by a few factors, including the International Staging System (ISS), chromosomal abnormalities, and combining those two with lactate dehydrogenase (LDH), or newer technologies like gene expressions.

All together, the definition of high-risk multiple myeloma is focused on disease outcomes. 

However, Dr. Charlotte Pawlyn (UK) researched and drew conclusions that looking at data across a lifespan, the relative impact or importance of chromosomal abnormalities tends to decrease, while "patient-centered" factors tend to increase with age.

What are these "patient-centered" factors? They could include things like diabetes, kidney function, heart problems or levels of physical activity. These factors could be related to myeloma, but also they could be attributed to old age comorbidities (other independent chronic conditions). 

So, Dr. Wildes challenged the ASCO audience, and she challenges us: consider reconstructing the framework of what high risk disease is defined as, to encompass not only disease-specific factors, but also characterizing the aging-associated vulnerabilities that are present in older patients with myeloma.

Essentially, is the patient actually high risk or do they just need help dealing with other aspects of their health so that they live longer?

Watch the full video here.