| Objective: To investigate the correlation between the percentage of bone marrow residual plasma cells,serum free light chain and clinical efficacy after induction therapy in patients with multiple myeloma and statistical analysis.It is used to assess the clinical significance of its impact on the depth of disease remission,judgment of efficacy,prediction of recurrence and early intervention.Methods:Thirty-six patients with newly diagnosed multiple myeloma were selected from Department of Hematology,Second Hospital of Hebei Medical University from January 2015 to January 2018.(The patients in this study met the diagnostic criteria in the 2015 NCCN guidelines,and Fluorescence in situ hybridization was performed at the time of initial diagnosis),the follow-up date was May 2018.The follow-up time was 1-40 months,and the median follow-up time was 20 months.Flow cytometry and immunoturbidimetric assay were used to detect the percentage of bone marrow residual plasma cells and serum free light chain in patients with multiple myeloma after the fifth course of induction therapy,and to analyze their correlation with clinical efficacy.Results:1.After five courses of induction therapy,8 patients were lost to the study(including a high-risk genetic abnormality),and the remaining 28 patients with multiple myeloma were counted.Six high-risk genetic abnormalities,non-high-risk genetic abnormalities A total of 22 cases.Among them,the high-risk genetic abnormality group reached 0 in the CR group,1 in the PR group(including PR+VGPR),2 in the SD group,and 3 in the PD group.The non-high-risk genetic abnormality group reached the CR group in 9 cases and the PR group(including PR +VGPR),8 cases,SD group,2 cases,PD group,3 cases.The results of statistical analysis indicated that compared with the high-risk genetic abnormality group,the non-high-risk genetic abnormality group could obtain better clinical efficacy,P=0.049,the difference was statistically significant.2.The survival curves of high-risk and non-high-risk genetic abnormalities were calculated by Kaplan-Meier method.The results showed that the median OS period of 28 months in high-risk genetic abnormalities patients was significantly shorter than that of non-high-risk genetic abnormalities patients(not reached within 40 months of follow-up),P=0.001,with significant difference.3.The mean concentration of serum kappa and lambda chains,median kappa/lambda ratio and quartile spacing in patients with multiple myeloma of type kappa and lambda were significantly different from those in normal subjects(Z kappa = 4.949,P < 0.001;Z lambda = 14.39,P = 0.001;Z kappa/lambda = 0.863,P = 0.038).The difference has statistical significance.4.The levels of serum free light chain in the partial remission group(including PR+VGPR),disease stabilization group and disease progression group were significantly higher than those in the complete remission group(P<0.05).The difference was statistically significant.5.Kaplan-Meier method was used to calculate survival curve of patients with sFLC.The results showed that the median OS period of 38 months in high sFLC group was significantly shorter than low sFLC group(not reached within 40 months of follow-up),P=0.023.The difference was statistically significant.6.After five courses of induction therapy,the percentage of bone marrow residual plasma cells was detected by flow cytometry.The results showed that there were 9 cases in the low tumor burden group and 19 cases in the high tumor burden group.Among them,there were 8 cases in CR group,1 case in PR group(1 case in 2 VGPR),0 cases in SD group and 0 cases in PD group in low tumor load group,1 case in CR group,8 cases in PR group(including 1 case of VGPR),4 cases in SD group and 6 cases in PD group in high tumor load group.The results of statistical analysis showed that compared with the higher tumor burden group,the low tumor burden group could obtain better clinical efficacy,P=0.047,the difference was statistically significant.7.The survival curves were calculated by Kaplan-Meier method.The results showed that the median OS period of 39 months in high-load group was significantly shorter than low-load group(not reached within 40 months of follow-up),P < 0.001.The difference was statistically significant.Conclusions:1.After induction therapy,high-risk and non-high-risk genetic abnormalities are associated with clinical efficacy and OS stage.2.After induction therapy,the levels of sFLC and rFLC are related to clinical efficacy and OS stage.3.After induction therapy,the percentage of bone marrow residual plasma cells detected by flow cytometry was correlated with clinical efficacy and OS stage. |
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