| Background:Multiple myeloma (multiple myeloma, MM) is a kind of malignant tumor which derived from plasma cells, the main clinical features of that disease cells is secreting large amounts of monoclonal immunoglobulin and restrictiveκ,λlight chain, and causing bone destruction, hyperviscosity, renal function impairing and other clinical manifestations. The incidence of Multiple myeloma account for about 10% among hematopoietic system tumors and 1% among body tumors.With the increasing of age, the incidence of Multiple myeloma is increasing。MM usually occur in the elderly, the ratio in male to female is 3:2, the median age of MM patients is about 60 years old in China, and 68 years old in Europe and the United States.The Incidence of MM in Asians is the lowest, followed by Caucasians, the highest in black race. MM is a highly heterogeneous disease, the median survival time was about 3 years, but the difference between the survival times is vary widely, ranging from months to 10 years. Every year, there are about 14,000 cases who are newly diagnosed MM, in recent years with the aging of our population, its incidence increased year by year, The disease threatened the life of the elderly and quality of life.Therefore, MM in elderly groups can not be ignored, that disease should be paied more attention. Elderly MM patients with poor general status, underlying many diseases, the main characteristics of poor organ function, these factors make the treatment more difficult. Therefore, deeper study of the clinical characteristics of elderly and prognosis has important clinical significance.Objective:Further clarify the pathogenesis of age-related characteristics of MM and explore the prognostic factors by analyzing clinical data of the elderly multiple myeloma (multiple myeloma, MM).Method:From January 2004 to January 2011 in our hospital and the First Clinical College, Jilin University,300 patients were treated MM patients, gender, age, white blood cells, hemoglobin, platelets, monoclonal immunoglobulin type, the proportion of tumor cells in bone marrow, serum albumin, serum lactate dehydrogenase (LDH), serum creatinine, uric acid, bloodβ2-microglobulin (β2-MG), serum calcium, urinary Bence Jones protein (Bence Jones protein, BJP), clinical stage and treatment methods of collection of clinical indicators. Statistical information separately, using Excel input data tabulation, statistical analysis software application SPSS17.0, calculated using Kaplan Meier cumulative survival, with Log-Rank test was used for univariate analysis, measurement data using t test with count dataχ2 test, P<0.05 as statistically significant, P<0.01 to have statistically significant. Multivariate analysis by COX proportional hazards regression model selected prognostic factors. To further clarify the pathogenesis of MM features senile, senile of these factors on the prognosis of patients with MM.Results:300 cases diagnosed as MM patients, male 172 cases, female 128 cases, male to female ratio is about 3:2, the patiens will be divided into age> 60 years old eldly group and≤60 years old of non-elderly group, eldly group has 134 cases,75 patients were male, female 59 cases, median age 67 years; non-elderly group has 166 cases 97 patients were male,69 females, median age 52 years. Elderly group compared with the non-elderly group, gender, disease duration time and first symptom has no significant difference in the immunophenotype, uric acid, LDH, WBC, platelet count and similar non-elderly group. However, the percentage of bone marrow plasma cells, serum calcium, serumβ2-MG, creatinine, BJP-positive rate was significantly higher than non-elderly group, P values were 0.037,0.006,0.026,0.024,0.032, ALB, Hb was significantly lower than non-elderly group (P=0.021), and the high incidence of infection in elderly patients (P=0.004), the differences were statistically significant. Affect the prognosis of elderly patients showed that a single factor analysis:gender, duration of time, immunophenotyping, uric acid, WBC, PLT, hemoglobin, serum calcium, LDH, creatinine, no significant differences, P values were greater than 0.05, while in the age, the proportion of tumor cells in bone marrow, blood ALB, serumβ2-MG, BJP, ISS stage, drug treatment were significantly different, P values were 0.04,0.05,0.004,0.001,0.001,0.00001,0.0001. At the result of the above factors into multivariate COX model analysis showed that ALB, serumβ2-MG, BJP, ISS stage, treatment of elderly patients is an independent prognostic factor in MM patients, P values were 0.025,0.026,0.017, 0.032,0.004.Conclusion:1. The elderly group of MM patients, bone marrow plasma cell percentage, serum calcium, serumβ2-MG, creatinine, BJP-positive rate was significantly higher than non-elderly group, the depression of serum albumin and hemoglobin levels is more obvious than non-elderly group, suggesting that elderly patients with newly diagnosed MM is more severe compared with non-weight condition.2. The infection rate was 29.9% in the eldly group, and 16.3% in non-elderly group, the eldly group significantly higher than non-elderly group, suggesting that the elderly MM patients complicated by infection, in the course of treatment should be strengthened to support treatment, and actively to control.3. Age, bloodβ2-MG, calcium, creatinine increased, a high percentage of myeloma cells, low serum albumin, BJP positive are all poor prognostic factor in MM patients.4. Serumβ2-MG, serum albumin, BJP, ISS stage of treatment for elderly patients with MM were independent prognostic factors.5. To the staging, ISS staging is more cortrelative with the prognosis of patients than DS installment.6. Compared with conventional treatment, drug treatment can prolong overall survival in elderly patients with MM time.
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