| Objective: At present,the clinical features,cytogenetic abnormalities and prognosis of patients with multiple myeloma in Chinese population are still not sufficient.This study aims to research the clinical features,cytogenetic abnormalities and its effect on treatment efficacy and prognosis in Chinese patients with multiple myeloma.To explore the efficacy of bortezomib-based combination chemotherapy in the treatment of primary multiple myeloma and the effect of adriamycin on cardiac function in patients with multiple myeloma during induction therapy.Methods: A retrospective study was performed on 93 patients with multiple myeloma diagnosed and treated at our hospital from March 2016 to June 2018.Fluorescence in situ hybridization(FISH)was used to detect cytogenetics of abnormal plasmocytes.Bortezomib-based PAD or PCD chemotherapy was used to treat patients.This study analyzed the clinical features,cytogenetic abnormalities,clinical stage,biochemical indices,treatment methods and other factors to discover their effect on the prognosis of the disease.The effect of the chemotherapy on the patient’s cardiac toxicity was analyzed by comparing the cardiac functional parameters including ECG and myocardial enzyme levels before and after the induction therapy in patients with multiple myeloma.Results: 93 patients(58 males and 35 females)with an average age of 61 years(34-80)were enrolled.A total of 12 cases(12.9%)were found to have TP53 site translocation,48 cases(51.6%)had translocation in lq21 site,12 cases(12.9%)had translocation in MAF site,and 14 cases(15.1%)had translocation in FGFR3 site.No significant correlation was found with the efficacy of induction therapy and above-mentioned translocation.The total response rate was different in patients with age≥65 years or with hemoglobin ≤ 120 g / L(p= 0.009,0.034).85 patients were divided into R-ISS stage I(17cases,18.3%),R-ISS stage II(63cases,66.7%)and R-ISS stage III(5 cases,5.3%)before treatment.After induction therapy,the odds ratio of ISS stage I,II,III patients were 85%,84.4%,57.1%(p=0.017),the ORR of R-ISS stage I,II,III patients were 94.1%,74.6%,40.0%(p=0.034).The rate of patients reached the ending of VGPR or above were 64.7%、32.4% 、 20.0%(p=0.033)for patients with R-ISS stage I,II,III.R-ISS is more suitable for stratifying patients’ risk.Conclusion: The clinical features and therapeutic efficacy of Chinese multiple myeloma patients in Shanghai are similar to those in Western countries.The R-ISS staging can make better risk stratification by including FISH to detect cytogenetic abnormalities.Therefore R-ISS staging can better guide patients in the follow-up treatment. |
