The Clinical Features And Prognostic Factors Of 320 Newly Diagnosed Multiple Myeloma Cases

ObjectiveThis study aims to explore the clinical characteristics and the prognostic factors that influence on progression-free survival(PFS) and overall survival(OS) of patients newly diagnosed with multiple myeloma in our hospital.MethodsA retrospective analysis was performed on clinical data of 320 multiple myeloma cases in Affiliated Union Hospital of Fujian Medical University from 1 June, 2010 to 30 June,2015. Demographic characteristics, clinical features and laboratory examination were recorded and 21 clinical and laboratory parameters were analyzed by univariate and multivariate process.Results1. 320 cases of MM patients including 194 males and 126 females, male: female =1.54: 1.Medium age of the whole group was 60 years old(ranged 26-85 years old),peak age of onset was 51-60 years old(34.4%). The beginning common symptoms of these patients in the study were bone pain(55.3%), imaging examinations showed:85.94%(275 cases) MM patients had varying degrees of bone destruction. Anemia was secondary pain symptoms(29.4%) when MM patients first diagnosed,laboratory tests showed: 72.5%(232 cases) MM patients had varying degrees of anemia(<100g / L). Ig G and Ig A were the most common sub-types of the newly diagnosed MM patients(respectively 53.2% and 26.2%), and the ISS stage were stage I 17.2%, stage II 52.2%, stage III 30.6%. The ECOG of the newly diagnosed MM patients were 0-1 among 83.8%(268 cases) and 2-4 among 16.2%(52 cases).2. The median OS of 294 cases MM patients who had complete follow-up data was 19 months.(1) 220 cases of patients receiving chemotherapy, the median PFS was 15 months, median OS was 20 months.(1)The univaried analysis identified 11 prognostic factors:Age, ISS stage, blood β2-MG, platelets, serum creatinine,calcium, corrected calcium, LDH, HBDH, genetics and bone marrow plasma cells were significantly associated with PFS. Multivariate analysis suggested that age,platelets, serum creatinine, corrected calcium were all independent prognostic factors for PFS.(2)The univaried analysis showed that 14 prognostic factors: age,ECOG score, ISS stage, bone disease classification, blood β2-MG, platelets, serum creatinine, calcium, corrected calcium, LDH, HBDH, genetics and bone marrow plasma cells, the degree of bone marrow plasma cell differentiation were significantly associated with OS. Multivariate analysis suggested that age, bone disease classification, platelets, serum creatinine, HBDH, corrected calcium were all independent prognostic factors for OS.(2)32 cases of patients not receiving chemotherapy, the median OS was 15 months. The univaried analysis identified that ISS stage, blood β2-MG, serum creatinine, calcium, corrected calcium were significantly associated with OS. Multivariate analysis suggested that ISS stage and corrected calcium were independent prognostic factors for OS.Conclusion1. The MM patients were mostly the middle and old age male patients. The common clinical manifestations were bone pain and anemia. Patients newly diagnosed of the disease were mainly on stage II in ISS.2. Patients who received chemotherapy, elderly, low platelets, kidney dysfunction,correctted hypercalcemia were all independent prognostic factors for PFS, and elderly, high levels of bone disease, low platelets, kidney dysfunction, high HBDH,correctted hypercalcemia were the independent prognostic factors for OS. Patients who did not receive chemotherapy, high ISS stage, corrected hypercalcemia were the independent prognostic factors for OS.3. Calcium value after the correction might have better prognostic effect.4. HBDH might serve as an independent prognostic factor for MM.