The Analysis Of Prognostic Factors And Efficacy In Patients With Multiple Myeloma

Objective:In order to analyze the features of morbidity,survival and mortality of multiple myeloma(MM)in our hospital,we collected relevant clinical datas of patients who admitted to our hospital in recent years.And we try to explore the factors that affect the prognosis and efficacy of newly diagnosed MM(NDMM)patients.Methods:We collected 210 NDMM patients who visited our hospital from January 2014 to October 2019.They all received at least four courses of chemotherapy.We performed a subgroup analysis of the patients according to different grouping methods.To analyze whether the age,stage,laboratory indicators,remission depth,and cytogenetic results of patients are related to the survival and efficacy.Results:We collected 210 patients with NDMM,most of whom were middle-aged and elderly(median age 58.5 years),with a male to female ratio of 1.12:1.According to M protein typing,IgG(46.19%)was the most common type,while the other types were IgA(29.05%),light chain(23.80%),IgM(0.48%),and non-secreted(0.48%).The Intemational Staging System(ISS)staging stage I-III patients accounted for 15.24%,41.43%and 43.33%,respectively.124 MM patients were tested with Fluorescence in situ hybridization(FISH),and the detection rate of FISH anomaly was 64.52%,including 17 cases of amplification with simple 1q21,14 cases of rearrangement with IgH,3 cases of simple 13q deletion,and 1 case of simple 17p deletion.The remaining45 patients were complicated with 2 or more cytogenetic abnormalities.As of February 2020,the median survival time of 210 patients had not yet reached,with an average survival time of 26.91+18.48 months(4.53-74.73).The overall survival rate was 70.48%.According to the analysis of clinical indicators of MM patients at the initial diagnosis,the results showed that ISS stage III group,renal dysfunction group,and MM patients with high cytogenetic risk had shorter overall survival time.Multivariate analysis showed that ISS stage III and cytogenetic high-risk were independent risk factors for MM patients.Conclusion:Patients with high ISS stage,renal dysfunction or high-risk cytogenetics at the initial diagnosis suggested that the total survival time of them was short.ISS stage III and high genetic risk were independent risk factors for poor prognosis.In patients with normal renal function and platelet level of 100*10~9/L,chemotherapy containing bortezomib can significantly improve ORR.In addition,patients with renal insufficiency,cytogenetic high risk or low hemoglobin levels have a higher risk of death.