Table 1.

Patient- and disease-based factors for the identification of high-risk MM

High-risk featuresDefinition
Patient-based factors  
 Frailty status IMWG frailty score
Modified IMWG frailty score
R-MCI
GAH 
Disease-based factors  
 Aggressiveness in the clinical presentation Extramedullary disease (no bone-related plasmacytomas)
Plasma cell leukemia
LDH elevated 
 Cytogenetic abnormalities del(17p), t(4;14), t(14;16), amp1q, del(1p) 
 Mutations TP53 
 Biochemical abnormalities LDH elevated
β2-microglobulin ≥5.5 mg/L
Albumin levels ≤3.5 mg/L 
Prognostic scores  
 R-ISS R-ISS III: beta2-microglobulin ≥5.5 mg/L plus either LDH elevated or high-risk CA (del(17p), t(4;14), or t(14;16)) 
High-risk featuresDefinition
Patient-based factors  
 Frailty status IMWG frailty score
Modified IMWG frailty score
R-MCI
GAH 
Disease-based factors  
 Aggressiveness in the clinical presentation Extramedullary disease (no bone-related plasmacytomas)
Plasma cell leukemia
LDH elevated 
 Cytogenetic abnormalities del(17p), t(4;14), t(14;16), amp1q, del(1p) 
 Mutations TP53 
 Biochemical abnormalities LDH elevated
β2-microglobulin ≥5.5 mg/L
Albumin levels ≤3.5 mg/L 
Prognostic scores  
 R-ISS R-ISS III: beta2-microglobulin ≥5.5 mg/L plus either LDH elevated or high-risk CA (del(17p), t(4;14), or t(14;16)) 

GAH, geriatric assessment in hematology; R-MCI, Revised Myeloma Comorbidity Index.

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