A multicenter study of R-ISS staging combined with frailty biomarkers to predict the prognosis and early death in newly diagnosed elderly multiple myeloma patients
10.3760/cma.j.issn.0254-9026.2023.10.011
- VernacularTitle:修订国际分期系统结合衰弱生物标志物预测老年初诊多发性骨髓瘤患者预后和早期死亡的多中心研究
- Author:
Yingjie ZHANG
1
;
Hua XUE
;
Mengyao LI
;
Jianmei XU
;
Xinyue LIANG
;
Weiling XU
;
Xiaoqi QIN
;
Qiang GUO
;
Shanshan YU
;
Peiyu YANG
;
Mengru TIAN
;
Tingting YUE
;
Mengxue ZHANG
;
Yurong YAN
;
Zhongli HU
;
Nan ZHANG
;
Jingxuan WANG
;
Fengyan JIN
Author Information
1. 吉林大学白求恩第一医院血液科，长春 130021
- Keywords:
Multiple myeloma;
Biological markers;
Neoplasm staging
- From:
Chinese Journal of Geriatrics
2023;42(10):1207-1212
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.
