The Relationship Between Serum Ig G Levels,Clinical Efficacy And Prognosis In Patients With Initial Diagnosis Of Ig G-Type Multiple Myeloma

Objective: 1.To determine the distribution of serum IgG levels in patients with IgG multiple myeloma(MM)at the time of initial diagnosis.2.To analyze the relationship between IgG levels and clinical efficacy and prognosis of newly diagnosed IgG-type MM patients.3.To analyze the differences in the efficacy between two different chemotherapeutic drugs,thalidomide(TM)and bortezomib(BTZ)in newly diagnosed IgG MM patients.4.To explore the relationship between serum IgG levels at the time of initial diagnosis and survival of IgG MM patients.To explore the effect of TM and BTZ on IgG MM patients.Methods: 1.This study collected the clinical data of 66 newly diagnosed IgG-type MM patients admitted to the Department of Hematology in our hospital from September 2012 to October 2018.These patients were divided into two groups,?64 g/L(group 1,n=41)and >64 g/L(group 2,n=25)according to the serum IgG levels at initial diagnosis.In addition,according to the accepted treatment regimen,group 1 and group 2 were divided into thalidomide(TM)group(group 1,n=22?group 2,n=13)and bortezomib(BTZ)group(group 1,n=19?group 2,n=12).2.The clinical efficacy,progression-free survival(PFS),overall survival(OS)and influencing factors of group 1 and group 2,TM group and BTZ group were analyzed respectively.3.Statistical analysis was performed using SPSS 22.0 software package.Normal distribution test was performed using a one-sample Kolmogorov-Smirnov test.The student's t-test was used to compare the data of two groups.The chi-square test was used to compare the data of multiple groups.The Spearman correlation analysis was used to analyze the correlation of these groups.The Kaplan-Meier analysis was used to analyze OS and PFS.Multivariate survival analysis was performed using the Cox regression model.P?0.05 was considered statistically significant.Results: 1.Serum IgG levels at initial diagnosis in patients with IgG-type MM showed a normal distribution(P=0.200).The overall IgG mean 60.59±25.05g/L,of which group 1 mean 45.31±15.24g/L,group 2 mean 85.66±16.10g/L.2.High-risk cytogenetics(HRCs)patients in group 2 were much more than those in group 1(P=0.022).3.Spearman correlation analysis showed that serum IgG levels were negatively correlated with albumin levels(r=-0.449,P=0.000)and hemoglobin levels(r=-0.608,P=0.000),and were positively correlated with bone marrow plasma cells(r=0.328,P=0.007).4.The clinical efficacy of group 1 was significantly better than that of group 2(P=0.008),and the deep response rate(CR+VGPR)of group 1 was better than that of group 2(P=0.036).5.There was no difference of clinical efficacy between the BTZ group in group 1 and the BTZ group in group 2(P=0.066),and also deep remission rate(P=0.653).The overall efficacy of TM group in group 1 was better than that in group 2(P =0.048)and the deep response rate of TM group in group 1 was better than that in group 2(P=0.05).6.Survival analysis showed that PFS and OS of group 1 were significantly better than those of group 2(PFS: P= 0.015,OS: P=0.049).Cox multivariate regression analysis showed that the maximum clinical efficacy?VGPR and standard-risk cytogenetics were independent prognostic factors.Conclusion: 1.Serum IgG levels in patients with IgG-type MM showed a normal distribution trend.2.The higher the serum IgG levels in patients with initial diagnosis of IgG-type MM,the higher the risk of cytogenetics,and the worse the clinical efficacy.3.The higher the serum IgG levels in patients with initial diagnosis of IgGtype MM,the worse the PFS and OS.4.There was no significant difference in clinical efficacy of BTZ on IgG-type MM patients with different IgG levels.