The international St-aging system as a prognostic marker in general senior population : findings from the EPIDOS cohort study

Marie Pouzoullic , Dolores Sánchez-Rodríguez , Regis Bataille (1) , Cédric Annweiler (2) , Anne-Marie Schott

1 Faculté de Médecine
2 LPPL - Laboratoire de Psychologie des Pays de la Loire

The International Staging System (ISS) -calculated from serum albumin and beta-2 microglobulin (β2m)- is an established prognostic marker in multiple myeloma (MM), which has also been suggested to account for survival among general senior population. Our objective was to examine long-term survival of older women free of MM according to baseline ISS. The study included 230 community-dwelling healthy older women without known MM from the EPIDOS cohort (mean ± SD, 80.4 ± 3.4 years). Serum albumin and β2m were measured at baseline, and used to calculate the ISS a posteriori. Abnormal ISS was defined as ISS = 2 or ISS = 3, although ISS = 1 was considered normal. The vital status was sought after a mean follow-up of 17.6 ± 0.2 years (range, 16.8–18.3). Age, body mass index, mean arterial pressure, diabetes mellitus, hypertension, coronary heart disease, stroke, use corticosteroids, number of drugs daily taken, smoking, physical activity, fall history, bone mineral density, and creatinine clearance were used as potential confounders. All participants died during the 17-year follow-up. Compared to women with normal ISS, those with abnormal ISS (n = 24) had shorter survival time (4.9 ± 4.3 versus 8.7 ± 5.2 years, P = .001) and died earlier (85.6 ± 4.8 versus 89.1 ± 5.6 years old, P = .003). Survival time after blood test correlated with both serum albumin (r = 0.16, P = .015) and β2m (r = −0.27, P < .001). Cox regression revealed that abnormal ISS was associated with mortality (adjusted HR = 3.03, P < .001). Kaplan-Meier distributions showed that participants with abnormal ISS died earlier than those with normal ISS (log-rank P < .001). In conclusion, community-dwelling older women with abnormal ISS had shorter survival time than the others, suggesting that ISS could be considered as a universal prognostic “aging system” rather than a specific MM “staging system”.

Mots clés: Albumin; Beta-2 microglobulin; Multiple myeloma international staging system; Prognosis; Survival; Older adults

Domaines: Gériatrie et gérontologie

Marie Pouzoullic, Dolores Sánchez-Rodríguez, Regis Bataille, Cédric Annweiler, Anne-Marie Schott. The international St-aging system as a prognostic marker in general senior population : findings from the EPIDOS cohort study. European Journal of Internal Medicine, 2019, 68, pp.51-54. ⟨10.1016/j.ejim.2019.07.031⟩. ⟨hal-03345452⟩