Clinical significance of corrected serum calcium level in newly-diagnosed multiple myeloma patients and analysis of influencing factors of concomitant hypercalcemia
10.3760/cma.j.cn115356-20241218-00184
- VernacularTitle:初诊多发性骨髓瘤患者校正血清钙水平的临床意义及合并高钙血症的影响因素分析
- Author:
Yujiao FENG
1
;
Caili PEI
;
Yan KANG
Author Information
1. 山西省肿瘤医院 中国医学科学院肿瘤医院山西医院 山西医科大学附属肿瘤医院输血科，太原 030013
- Keywords:
Multiple myeloma;
Hypercalcemia;
β 2-Microglobulin
- From:
Journal of Leukemia & Lymphoma
2025;34(7):416-421
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the relationship between corrected serum calcium level and clinical characteristics in patients with newly-diagnosed multiple myeloma (MM), as well as the influencing factors of concomitant hypercalcemia.Methods:A retrospective case cohort study was conducted. The clinical data of newly-diagnosed MM patients who were admitted to Shanxi Province Cancer Hospital from January 2020 to December 2023 were collected. When serum albumin (ALB) was less than 40 g/L, the serum calcium level was corrected. The hypercalcemia group was defined as the corrected serum calcium level >2.60 mmol/L, the normal blood calcium group was defined as 2.20-2.60 mmol/L, and the hypocalcemia group was defined as <2.20 mmol/L; the combination of normal blood calcium group and hypocalcemia group was the non-hypercalcemia group. The age, gender, immune typing, ALB, blood urea nitrogen (BUN), serum creatinine (Scr), β 2-microglobulin (β 2-MG), and alkaline phosphatase (ALP) of patients in the hypercalcemia group and the non-hypercalcemia group were compared. Pearson correlation analysis was used for the correlation analysis. The logistic regression model was used to conduct multivariate analysis on the influencing factors of hypercalcemia. Results:Before correction, there were 31 cases (26.5%), 48 cases (40.0%) and 38 cases (32.5%) of MM patients in the hypocalcemia group, normal blood calcium group and hypercalcemia group, respectively. After correction, there were 17 cases (14.5%), 58 cases (49.6%) and 42 cases (35.9%), respectively. The corrected serum calcium level for male MM patients was (2.58± 0.41) mmol/L, while for females it was (2.53±0.38) mmol/L, and there was no statistically significant difference between the two groups ( t = 0.79, P > 0.05). The corrected serum calcium levels for patients in stage Ⅰ, stage Ⅱ and stage Ⅲ of the International Staging System (ISS) were (2.31±0.15) mmol/L, (2.52±0.37) mmol/L and (2.65±0.42) mmol/L, respectively, and the difference between the three groups was statistically significant ( F = 53.62, P < 0.01). Corrected serum calcium showed a negative correlation with patients' serum ALB ( r = -0.201, P < 0.05), and positive correlations with Scr, BUN and β 2-MG levels ( r values were 0.470, 0.247 and 0.469, respectively, all P < 0.01), but it had no correlation with age or ALP ( r values were -0.013 and 0.078, respectively, both P > 0.05). There were 15 cases (17.1%), 48 cases (54.5%) and 25 cases (28.4%) of patients with normal renal function in the hypocalcemia group, normal blood calcium group and hypercalcemia group, respectively; there were 2 cases (6.9%), 10 cases (34.5%) and 17 cases (58.6%) of patients with impaired renal function in the hypocalcemia group, normal blood calcium group and hypercalcemia group, respectively; there were statistically significant differences between the hypocalcemia group and the hypercalcemia group, as well as between the normal blood calcium group and the hypercalcemia group ( χ2 = 4.57, P < 0.05; χ2 = 6.67, P < 0.05), but there was no statistically significant difference between the hypocalcemia group and the normal calcium group ( χ2 = 0.29, P>0.05). The patients with approximately normal bone status in the hypocalcemia group, normal blood calcium group and hypercalcemia group were 3 cases (13.0%), 17 cases (74.0%) and 3 cases (13.0%), respectively, and the patients with bone damage were 14 cases (14.9%), 41 cases (43.6%), and 39 cases (41.5%), respectively, and there was a statistically significant difference between the normal blood calcium group and the hypercalcemia group ( χ2 = 7.48, P < 0.01), while there was no statistically significant difference between the hypocalcemia group and the hypercalcemia group ( χ2 = 1.46, P > 0.05). The proportions of patients with Scr > 177 μmol/L and β 2-MG > 3.5 mg/L in the hypercalcemia group were higher than those in the non-hypercalcemia group, and the differences were statistically significant (both P < 0.05). The results of logistic regression multivariate analysis showed that β 2-MG >3.5 mg/L was an independent risk factor for hypercalcemia in newly-diagnosed MM patients ( OR = 1.178, 95% CI: 1.058-1.311, P = 0.003). Conclusions:Corrected serum calcium level may be an important indicator for evaluating the severity of disease, renal function and bone status in newly-diagnosed MM patients.
