Explore The Value Of Red Blood Cell Distribution Width In The Prognosis And Alternative Chemotherapy Of Multiple Myeloma

Objective:Retrospective analysis of multiple myeloma(MM)patients to explore the value of red blood cell distribution width in the prognosis of multiple myeloma and the choice of chemotherapy options.Methods:Patients with multiple myeloma were first diagnosed at the Second Affiliated Hospital of Nanchang University from January 2011 to December 2018.The red blood cell distribution width(RDW)of MM patients was collected.The ROC curve was drawn according to ISS staging.The optimal cut point of RDW was selected and the cutoff value was 15.25%.MM patients were divided into high RDW group and low RDW group.Differences and differences in prognosis.Results:(1)The mean RDW of MM group and healthy control group were 15.92%±2.46% and 12.60%±0.57%,respectively,the difference was statistically significant(P<0.001);82 patients had RDW and 4 cycles before treatment.The RDW after chemotherapy was 15.92% ± 2.46% and14.76%±1.27%,respectively,and the difference was statistically significant(P<0.001).(2)Compared with the lower RDW group,the ISS stage and DS stage were higher in the high RDW group,but there was no significant difference in response to treatment between the two groups(P>0.05).(3)In the high RDW group,the median PFS of the bortezomib-containing chemotherapy subgroup and the bortezomib-free chemotherapy subgroup were 32 months and 15 months,respectively,and the OS was 58 months and 30 months,respectively,The difference was statistically significant(P<0.001).In the low RDW group,the median PFS of the bortezomib-containing chemotherapy subgroup and thebortezomib-free chemotherapy subgroup were 40 months and 31 months,respectively,and the OS was 53 months and 49 months,respectively,Not statistically significant(P>0.05).(4)In the high RDW group: single factor analysis and multivariate analysis found that bortezomib-containing chemotherapy suggested longer PFS and OS;in the low RDW group: single factor analysis and multivariate analysis found that white blood cells >4×109/L prompts for longer PFS and OS.Conclusions:1.The level of RDW in patients with newly diagnosed MM is higher than that in healthy people,and the level of RDW in MM patients is negatively correlated with their prognosis;2.Compared with the bortezomib-free regimen,patients with high RDW levels were treated with a bortezomib regimen for better outcomes,whereas for the low RDW group,there was no difference in the efficacy of the two regimens.