Clinical features and prognosis of patients with functional high-risk myeloma
Objective To analyze the clinical features and prognostic factors of patients with functional high-risk myeloma(FHR).Methods From January 2017 to May 2022,53 patients with multiple myeloma(MM)admitted to the Department of Hematology of the Second Affiliated Hospital of Harbin Medical University from diagnosis to recurrence and poor induction were in-cluded.According to the recurrence time,MM patients with recurrence less than 12 months were classified as FHR group(n=24),and those with recurrence more than 12 months were classified as control group(n=29).The sex,age and clinical data of patients in the two groups were statistically analyzed,and the risk factors were screened by Logistic regression model step by step,and meaningful clinical indicators were screened out.The high risk factors of early recurrence were discussed by multivariate analysis.In addition,patients with high-risk cytogenetic abnormality(HRCA)at the time of initial diagnosis were classified as gene high-risk(GHR)group,and the rest patients without HRCA were regrouped according to the recur-rence time of the disease.They were divided into revised-functional high risk(R-FHR)group(≤12 months)and standard risk(SR)group(＞12 months).Kaplan-Meier method was used to draw the survival curve,and the influence of recurrence time on overall survival(OS)was analyzed.Results ①Compared with the control group,the incidence of extramedullary dis-ease(EMD)in FHR group was higher(16.67％vs 0.00％,P=0.022).The proportion of patients with HRCA at initial diagnosis was significantly higher than that of the control group(41.67％vs 13.79％,P=0.022).After first-line treatment,the very good partial response,VGPR)rate and the overall response rate(ORR)of patients in FHR group and control group were 20.83％vs 82.76％and 87.5％vs 100％,respectively.The former had poor curative effect,and the difference between the two groups was statistically significant(P＜0.001);②The median follow-up time of all patients was 32.08(23.87～44.03)months.The median OS of patients in FHR group and control group was 24.0 months vs 65.8 months respectively(P＜0.05);③Among 53 patients with MM,there were 14 patients in GHR group,14 patients in R-FHR group and 25 patients in SR group.Survival analysis showed that the median OS of SR,R-FHR and GHR groups was 65.8 months,23.0 months,and 32.0 months,respectively(P＜0.05).Conclusion FHR patients have poor response to initial treatment and a high propor-tion of extramedullary lesions.Even if any high-risk cytogenetic factors are excluded,the over-all survival time is still significantly shortened,which requires clinicians' high attention.
万方数据
维普
