{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:45:56Z","timestamp":1791812756683,"version":"4.3.4"},"reference-count":13,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Established disease\u2010centered prognostic systems may be less tailored to elderly\/non\u2010transplant\u2010eligible (NTE) patients with multiple myeloma (MM), in whom host\u2010related factors such as age, performance status, and renal function strongly influence all\u2010cause outcomes. We developed and evaluated the Myeloma Elderly Prognostic Score (MEPS), a pragmatic four\u2010factor score integrating age\u2009\u2265\u200975\u2009years, renal function\u2009&lt;\u200940 by eGFR or available creatinine clearance (CrCl), ECOG performance status\u2009\u2265\u20092, and ultra\u2010high\u2010risk cytogenetics, using baseline registry data from 881 newly diagnosed NTE MM patients from Greece, with OS analyses performed in the 878 patients with evaluable survival follow\u2010up, and externally evaluated it in an independent Portuguese cohort. In the Greek OS\u2010evaluable cohort, 485 deaths were observed. Median OS by MEPS group was 96, 65, 39, and 15.3\u2009months for scores 0, 1, 2, and \u2265\u20093, respectively. In a baseline score\u2010level Cox model, each ordinal MEPS category increase was associated with inferior OS (HR 1.74, 95% CI 1.58\u20131.92;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). MEPS showed higher OS discrimination than R2\u2010ISS in the Greek cohort (C\u2010index 0.655 vs. 0.602; bootstrap delta 0.053, 95% CI 0.021\u20130.085). The Portuguese validation dataset included 300 patients, of whom 290 were evaluable for the primary OS analysis, with 151 deaths. Median OS was 59.6\u2009months (95% CI 52.4\u201375.7), and MEPS again showed higher discrimination than R2\u2010ISS (C\u2010index 0.729 vs. 0.647; bootstrap delta 0.082, 95% CI 0.041\u20130.127). MEPS provides a simple all\u2010cause prognostic tool for elderly\/NTE MM, complementing biologically oriented staging with routinely available host\u2010related variables.\n                  <\/jats:p>","DOI":"10.1002\/ajh.70479","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:03:56Z","timestamp":1787565836000},"page":"2758-2765","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Myeloma Elderly Prognostic Score (\n                    <scp>MEPS<\/scp>\n                    ): A Proposed Prognostic Score Integrating Age, Renal Function, Performance Status, and Ultra\u2010High\u2010Risk Cytogenetics"],"prefix":"10.1002","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9404-807X","authenticated-orcid":false,"given":"Eirini","family":"Katodritou","sequence":"first","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Velosa","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Hemato\u2010Oncology Department Champalimaud Foundation, Lisbon, Portugal  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8191-5832","authenticated-orcid":false,"given":"Efstathios","family":"Kastritis","sequence":"additional","affiliation":[{"name":"School of Medicine, Athens, Clinical Therapeutics National and Kapodistrian University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6987-4716","authenticated-orcid":false,"given":"Dimitra","family":"Dalampira","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4985-5862","authenticated-orcid":false,"given":"Emmanouil","family":"Spanoudakis","sequence":"additional","affiliation":[{"name":"Alexandroupolis, Hematology Democritus University  Alexandroupolis Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-3012","authenticated-orcid":false,"given":"Joana","family":"Vieira","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Santa Maria (ULS Santa Maria)  Lisbon Portugal"},{"name":"Faculdade de Medicina de Lisboa  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7523-7510","authenticated-orcid":false,"given":"Sosana","family":"Delimpasi","sequence":"additional","affiliation":[{"name":"Hematology and Bone Marrow Transplantation Unit Evangelismos General Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-9783","authenticated-orcid":false,"given":"Ioannis","family":"Ntanasis\u2010Stathopoulos","sequence":"additional","affiliation":[{"name":"School of Medicine, Athens, Clinical Therapeutics National and Kapodistrian University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aikaterini","family":"Daiou","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Martins","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Santa Maria (ULS Santa Maria)  Lisbon Portugal"},{"name":"Faculdade de Medicina de Lisboa  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6180-1819","authenticated-orcid":false,"given":"Elpiniki","family":"Rentzeperi","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6926-0351","authenticated-orcid":false,"given":"Foteini","family":"Theodorakakou","sequence":"additional","affiliation":[{"name":"School of Medicine, Athens, Clinical Therapeutics National and Kapodistrian University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Karadrakonti","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graca Luiza O. P.","family":"Neto Vasconcelos Esteves","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Santa Maria (ULS Santa Maria)  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7185-7562","authenticated-orcid":false,"given":"Vasiliki","family":"Tara","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4544-0221","authenticated-orcid":false,"given":"Vasiliki","family":"Douka","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Unit \u201cG. Papanikolaou\u201d General Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0818-330X","authenticated-orcid":false,"given":"Dionysios","family":"Stoumpos","sequence":"additional","affiliation":[{"name":"Hematology Metaxa Cancer Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xanthippi","family":"Dimitriadou","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina Isabel Batista Geraldes","family":"Santos","sequence":"additional","affiliation":[{"name":"Clinical Hematology Service Unidade Local de Sa\u00fade de Coimbra (ULS Coimbra)  Coimbra Portugal"},{"name":"Faculty of Medicine University of Coimbra (FMUC)  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Palaska","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology Theagenio Cancer Hospital  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tsirogianni","sequence":"additional","affiliation":[{"name":"Hematology Agios Savvas Cancer Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kotsopoulou","sequence":"additional","affiliation":[{"name":"Hematology Metaxa Cancer Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7811-9509","authenticated-orcid":false,"given":"Rui","family":"Bergantim","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade S\u00e3o Jo\u00e3o  Porto Portugal"},{"name":"Institute for Research and Innovation in Health  Porto Portugal"},{"name":"Faculty of Medicine University of Porto (FMUP)  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gavriatopoulou","sequence":"additional","affiliation":[{"name":"School of Medicine, Athens, Clinical Therapeutics National and Kapodistrian University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4194-9119","authenticated-orcid":false,"given":"Adriana","family":"Roque","sequence":"additional","affiliation":[{"name":"Clinical Hematology Service Unidade Local de Sa\u00fade de Coimbra (ULS Coimbra)  Coimbra Portugal"},{"name":"Faculty of Medicine University of Coimbra (FMUC)  Coimbra Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2050-8082","authenticated-orcid":false,"given":"Konstantinos","family":"Kostikas","sequence":"additional","affiliation":[{"name":"HIPA (Health Information Platform Services)  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-3254","authenticated-orcid":false,"given":"Meletios A.","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"School of Medicine, Athens, Clinical Therapeutics National and Kapodistrian University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3978-766X","authenticated-orcid":false,"given":"Cristina","family":"Jo\u00e3o","sequence":"additional","affiliation":[{"name":"Hemato\u2010Oncology Department Champalimaud Foundation, Lisbon, Portugal  Lisbon Portugal"},{"name":"NOVA Medical School Nova University  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5133-1422","authenticated-orcid":false,"given":"Evangelos","family":"Terpos","sequence":"additional","affiliation":[{"name":"School of Medicine, Athens, Clinical Therapeutics National and Kapodistrian University  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)00135\u20105"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010020\u20100918\u20106"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.2128"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fepid.2025.1568688"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.61.226"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02614"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010019\u20100595\u20105"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO\u201024\u201001893"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102014\u201012\u2010615187"},{"issue":"2","key":"e_1_2_10_11_1","first-page":"25","article-title":"Random Survival Forests for R","volume":"7","author":"Ishwaran H.","year":"2007","journal-title":"R News"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1214\/08-AOAS169"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190601126602"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022017635"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.70479","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ajh.70479","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.70479","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:56:45Z","timestamp":1791809805000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.70479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1002\/ajh.70479"],"URL":"https:\/\/doi.org\/10.1002\/ajh.70479","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]},"assertion":[{"value":"2026-03-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}