| Background:Multiple myeloma(MM)is a kind of rare malignant proliferation of hematopoieti c system disease.The tumor and host factors is a major cause of affecting the prognosis.Existing commonly used clinical prognostic scoring system mainly includes: the DS,ISS s tage stage and R-ISS stage.Existing commonly used clinical prognostic scoring system m ainly include: micro globulin,albumin levels and cytogenetic abnormalities.The main reacti on load and tumor malignant degree,does not relate to the host factors.Host factors includ ing age,physical condition and complications.MM prognostic factors,the current research about into the host factors are: the peripheral blood lymphocyte count(ALC)and mononu clear cell count(AMC),lymphocyte count/monocyte count(LMR)and red blood cell distri bution width(RDW)closely related to the prognosis of patients with blood cancer;The c urrent research has shown that RDW(on behalf of the state of inflammation in patients w ith)associated with disease progression and poor prognosis in patients with MM;Body M ass index(BMI)is the most commonly used to measure the weight and height ratio of t he tool.It USES the ratio between the height and weight to measure whether a person to o thin or too fat.Studies have shown that BMI is associated with solid tumor progressionand poor prognosis,namely lower BMI prognosis is poorer,high or normal BMI relativel y good prognosis.COR-BMI is based on RDW and BMI,reaction in patients with infla mmatory status and physical differences,has proven to be affected laryngeal squamous cellcarcinoma of the specificity of nasopharyngeal carcinoma(NPC),important independent p rognostic factors of survival.But so far,about the COR-BMI of prognosis in patients wit h multiple myeloma is yet to be further determine the presence of predictive value.Objective:ALC,AMC,LMR and RDW for different types of diseases have been reported of inflammatory biomarkers and prognostic factor.COR-BMI is based on RDW and BMI,reaction in patients with inflammatory status and physical differences,has proven to be a ffected laryngeal squamous cell carcinoma of the specificity of nasopharyngeal carcinoma(NPC),important independent prognostic factors of survival.This study investigates the CO R-BMI prognostic value in multiple myeloma(MM),and combined with other factors re lated to prognosis were analyzed.Methods:Onset of henan province people's hospital were retrospectively analyzed between 2019 in October 2012 to present was treated 209 cases of MM,draw on patients with cli nical and laboratory data to begin with,and the treatment of patients with follow-up,dise ase progression and survival situation,follow-up deadline is November 31,2019.Using SP SS22.0 statistical software for processing,using descriptive analysis to general data analysi s,the subjects operating characteristic(ROC)curve analysis may affect survival in patientswith continuous variables,and to calculate the optimum threshold,survival analysis usingthe method of Kaplan Meier-were analyzed,and the prognosis of single factor analysisand multiple factor analysis respectively using the log-rank test and COX proportional hazards model.Results:1.209 patients in 110 cases of male,female 99 cases,the median age of 60 yea rs old(35-88 years);The median overall survival(OS)of 35.6 months(2.2-79.3 month);2.COR-BMI score is divided into three groups: RDW ? 13.1 and BMI > 25patients were defined as COR-BMI(0);RDW ? and BMI < 13.1 to 18.5 or 18.5 ?BMI < 25,RDW > 13.1 and 18.5 ? BMI < 25 or a BMI of 25 or more patients are defined as COR-BMI(1);RDW and BMI > 13.1 < 18.5 patients were defined as COR-BMI(2).The COR-BMI 0 group of 23 cases(11%),1 COR-BMI group of 178 c ases(85.2%),2 COR-BMI group of 8 cases(3.8%).Chi-square test and fisher inspectionshow COR-BMI and hemoglobin(P = 0.007),the COR-BMI and LDH was statistica lly significant(P = 0.047),and the COR-BMI with gender,age,proportion of ISS stage,plasma cells,bone marrow,serum creatinine,serum calcium,?2 microglobulin,immune classification,treatment,death results and marrow infiltration no correlation(P > 0.05).CO R-BMI and body load and the malignant degree of no correlation indexes,according tothe group by the COR-BMI can be a better prognosis,as a result of high degree of malignant tumor;3.Single factor analysis,according to the results of MM patients with age to beg in with,LDH,the choice of treatment,COR-BMI was an independent predictor of OS(P < 0.05),of which the age 60 years or more,220 iu/L LDH acuity,treatment for tradit ional chemotherapy regimens and COR-BMI 2 group(RDW > 13.1 and BMI < 18.5 pa tients)are the risk factors of death in patients with impact;4.Multiariable Cox proportional hazards analysis results showed that age,treatment,COR-BMI was an independent predictor of OS(P < 0.05).And RDW,BMI is can be used to evaluate therapeutic effect of simple easy measured parameters.MM patients ag ed 60 or higher to begin with,for traditional chemotherapy treatment scheme and COR-BMI 2 group(RDW > 13.1 and BMI < 18.5 patients)are independent risk factors influen cing patients died;5.In patients of this research on the ISS in installment,I/II 85 cases,III 124 ca ses,including I/II interim COR-BMI 1 group of patients(69 cases)and the COR-BM I 0 group(10 cases)OS higher than 2 COR-BMI group(6 cases)(Log-rank,P < 0.001).Conclusion:1?COR-BMI and body load and the malignant degree of no correlation indexes,according to the group by the COR-BMI can be a better prognosis,as a result of high degree of malignant tumor;COR-BMI(higher RDW values,lower BMI)is the independent risk factors of affect the MM death;2?In parameters included in the study,the age,the choice of treatment for the prognosis of patients with MM tip has a larger value,the higher age and treatment for the traditional chemotherapy regimens are the independent risk factors of death in patients with impact;3?After the ISS stage,patients with stage I/II,the COR-BMI scoring system in three groups,can still get a COR-BMI 1/0 COR-BMI 2 group is obviously better than the group OS,COR-BMI score system can be used as a useful supplement ISS stage;4?COR-BMI can be a better prognostic assessment primary-care MM,joint tumor and patient factors related indicators may for more accurate prediction of prognosis of MM.5?This study is a retrospective study,need large sample of the prospective cohort study was further confirmed. |
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