OBJECTIVE: To investigate the significance of HALP score as a prognostic indicator for newly diagnosed multiple myeloma (MM). METHODS: Clinical data of 62 newly diagnosed MM patients in our hospital from January 2020 to December 2022 were collected and retrospectively analyzed. The difference in age, sex, DS stage, R-ISS stage, M protein type, serum creatinine (Scr), β₂-microglobulin (β₂-MG), blood calcium, lactate dehydrogenase (LDH), hemoglobin (Hb), albumin (ALB), platelet count (PLT), and absolute lymphocyte count (ALC) between patients with low and high HALP scores were analyzed. The prognostic value of the above indexes in newly diagnosed MM patients was analyzed by univariate and multivariate analysis. RESULTS: The optimal cut-off value of HALP score was 41 determined by X-tile software. Based on this, 62 patients were divided into a high HALP group (HALP>41, n=25) and a low HALP group (HALP≤41, n=37). The proportion of patients with Hb≥100 g/L in the high HALP group was significantly higher than that in the low HALP group (P <0.05). The median overall survival (OS) time of patients in the high HALP group and low HALP group were 29 (9-39) months and 20 (4-29) months, respectively, with statistically significant difference between the two groups (P <0.01). Univariate analysis showed that R-ISS stage, ALB, Hb, ALC and HALP were closely related to the prognosis of patients (P <0.05). COX regression multivariate analysis showed that R-ISS stage Ⅲ (HR=4.443, 95%CI : 1.480-13.343，P =0.008) and HALP≤41(HR=8.823, 95%CI : 1.858-41.910，P =0.006) were independent risk factors for shortened OS in newly diagnosed MM patients. The median OS of patients with high HALP at R-ISS stage Ⅲ was significantly higher than that of patients with low HALP at the same stage, and the difference was statistically significant (P <0.05). CONCLUSION HALP score can be used as a prognostic indicator for newly diagnosed MM patients.
Humans ; Multiple Myeloma/diagnosis* ; Prognosis ; Retrospective Studies ; Male ; Female ; Middle Aged ; Aged ; beta 2-Microglobulin ; Lymphocyte Count

OBJECTIVE: To explore the influencing factors on the prognosis of patients with multiple myeloma (MM) after bortezomib treatment, and construct a decision tree risk prediction model based on the influencing factors. METHODS: One hundred and seventy MM patients admitted to the People's Hospital of Jianyang City from January 2019 to June 2022 were selected as research subjects, and divided into poor prognosis group and good prognosis group according to the prognosis after bortezomib treatment. The clinical data of the patients were analyzed, univariate and logistic regression analysis were used to screen influencing factors, SPSS Modeler software was used to construct a decision tree prediction model, and the diagnostic performance of the decision tree risk prediction model was analyzed. RESULTS: The incidence of poor prognosis in 170 MM patients after bortezomib-based chemotherapy was 21.18%. Kappa light chain level≥19.4 mg/L, platelet count (PLT) ≤100×10⁹/L, homocysteine (Hcy) >22 μmol/L, serum creatinine (Scr) ≥176 μmol/L, lactate dehydrogenase (LDH) ≥300 U/L, serum ferritin (SF) >500 mg/L, and β₂-microglobulin (MG) >6 μg/L were independent risk factors for poor prognosis in MM patients after bortezomib treatment (all P < 0.05). The decision tree model selected 7 explanatory variables (Kappa light chain level, LDH, PLT, SF, β₂-MG, Scr, and Hcy) as nodes of the model, among which Kappa light chain level was the most important predictor. In addition, the area under the ROC curve (AUC) values of the decision tree model and logistic regression model were 0.895 and 0.881, respectively. The prediction performance of the decision tree model was better than that of the logistic regression model ( Z=3.325, P =0.005). CONCLUSION The decision tree model has high value in predicting the prognosis after bortezomib treatment in MM patients, which can screen high-risk factors that affect poor prognosis, providing practical references for clinical healthcare professionals to take preventive treatment for high-risk MM patients.
Humans ; Bortezomib/therapeutic use* ; Multiple Myeloma/diagnosis* ; Decision Trees ; Prognosis ; Algorithms ; Risk Factors ; Male ; Female ; Middle Aged

OBJECTIVE: To investigate the influece of early relapse in the era of novel drugs on the prognosis of the patients with newly diagnosed multiple myeloma（NDMM） and risk factors, and to provide the basis for the early identification of the high-risk patients and guiding the treatment. METHODS: The clinical data of the patients with NDMM admitted to our hospital from November 2011 to May 2022 were retrospectively analyzed. According to whether the progression free survival（PFS） was more than 12 months, they were divided into early relapse group（≤12 months） and late relapse group（＞12 months）. The high-risk factors of the patients in two groups were analyzed, including age, anemia, renal insufficiency, hypercalcemia, increasing of lactate dehydrogenase（LDH） level, Extramedullary disease (EMD), International Staging System（ISS） stage, Revised International Staging System （R-ISS） stage, cytogenetic abnormalities(CA) detected by fluorescence in situ hybridization（FISH）, and treatment efficacy. The meaningful clinical indicators were screened, and multivariate analysis was used to explore the high-risk factors of early relapse. RESULTS: 170 patients with NDMM were collected, including 25 cases in early relapse group and 145 cases in late relapse group. The median OS time of the patients in early death group was 20 months, and 140 months in late relapse group by the end of follow-up, there was significant difference in OS of the patients between two groups（P<0.001）. Fifteen patients（56.0％）in early relapse group obtained ≥VGPR, and 113（77.9%） patients in late relapse group, the difference was statistically significant（P=0.011）. Survival outcomes remained poor among early relapse patients irrespective of depth of response to initial therapy. Multivariate analysis showed that the EMD and high-risk CA predicted early relapse. CONCLUSION The prognosis of patients with early relapse in NDMM is poor. EMD and high-risk CA is an independent prognostic factor of early relapse.
Humans ; Multiple Myeloma/diagnosis* ; Prognosis ; In Situ Hybridization, Fluorescence ; Retrospective Studies ; Neoplasm Recurrence, Local ; Risk Factors

Humans ; Multiple Myeloma/diagnosis* ; Plasma Cells ; Bone Marrow

OBJECTIVE: To investigate the correlation of peripheral blood platelet/lymphocyte ratio (PLR) with Treg and Th17 and its influence on prognosis in newly diagnosed multiple myeloma (MM). METHODS: One hundred thirty-five newly diagnosed multiple myeloma patients admitted to the Department of Hematology of Zhengzhou People's Hospital from June 2015 to October 2022 were selected as MM group. Clinical data included sex, age, immune typing, ISS stage, blood calcium (Ca), albumin (ALB), hemoglobin (Hb), PLR, LDH, β₂ microglobulin (β₂-MG), Treg and Th17 levels. Sixty healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. PLR, Treg and Th17 levels in MM group and control group were compared. Pearson was used to analyze the correlation between PLR and Treg, Th17. The relationship between MM patients with different PLR and clinical features and prognosis was analyzed. RESULTS: The PLR and Th17 of MM patients were significantly higher than that of control group, and Treg was significantly lower than that of control group (P<0.05). In MM patients, PLR was negatively correlated with Treg (r=-0.616), and PLR was positively correlated with Th17 (r=0.555). Using mean PLR=132.72 as the boundary, 135 MM patients were divided into high PLR group (n=54) and low PLR group (n=81). In MM patients with high PLR, ISS stage, ALB and Treg were significantly higher than those in low PLR group, while Th17 was significantly lower than those in low PLR group (P<0.05). By univariate and COX regression analysis, PLR was an independent prognostic risk factor for newly diagnosed MM patients (P<0.05). MM patients with high PLR had better PFS and OS, and the difference was statistically significant compared with MM patients with low PLR (P<0.05). 65 patients admitted from June 2015 to December 2018 were used as the training set, and 70 patients admitted from January 2019 to October 2022 were used as the validation set. The OS of MM patients with different PLR were compared respectively. The results showed that the conclusions of the training set and the validation set were consistent. PLR with high expression had higher OS (P<0.01). CONCLUSION PLR is correlated with Treg and Th17 in newly diagnosed MM patients, and high PLR has better prognosis. PLR can be used to evaluate the prognosis of MM patients.
Humans ; Multiple Myeloma/diagnosis* ; Blood Platelets ; T-Lymphocytes, Regulatory ; Prognosis ; Th17 Cells ; Retrospective Studies

OBJECTIVE: to analyze the effect of circulating plasma cells(CPC) on the prognosis of patients with multiple myeloma(MM) in the era of new drugs, and to explore the new definition standard of primary plasma cell leukemia(pPCL). METHODS: The clinical data of 321 patients with newly diagnosed MM and 21 patients with pPCL admitted to our hospital from January 2014 to May 2022 were retrospectively analyzed. According to the proportion of CPC in peripheral blood smears, all patients were divided into 4 groups: CPC 0% group(211 cases), CPC 1%-4% group(69 cases), CPC 5%-19% group(41 cases) and CPC≥20% group(21 cases). The clinical features of patients in each group were compared and the prognosis fators was analyzed. RESULTS: The median OS of the four groups were 44.5,21.3,24.6 and 12.8 months, respectively. Among them, 295 patients(86.3%) were treated with new drugs, and the median OS of the four groups were not reached, 26.7, 24.6 and 14.9 months, respectively. As the survival curves of CPC 5%-19% group and CPC≥20% group were similar, the patients were divided into CPC<5% group and CPC≥5% group, the median OS of CPC<5% group was better than that in CPC≥5% (43.5 vs 22.3 months, P<0.001). In addition, the median OS of patients in the CPC 1%-4% group was also significantly lower than that in the CPC 0% group and similar to that in the CPC≥5% group. Multivariate analysis showed that 1%-4% CPC was an independent risk factor for the OS of patients with CPC<5%. The patients with CPC<5% were stratified by R-ISS staging, and the OS of R-ISS stage Ⅰ or stage Ⅱ with 1%-4% CPC was similar to that of R-ISS stage Ⅲ. The newly defined pPCL patients showed increased tumor load and obvious invasive characteristics. Multivariate analysis showed no independent prognostic factors for pPCL, and high-risk cytogenetic abnormalities(HRCA) had no significant effect on the prognosis. CONCLUSION The validity of IMWG's new pPCL definition standard was verified, and it was found that the survival of MM with 1%-4% CPC also is poor and the prognosis is very close to pPCL. In addition, the newly defined pPCL has unique clinical and biological characteristics.
Humans ; Multiple Myeloma/pathology* ; Plasma Cells/pathology* ; Retrospective Studies ; Prognosis ; Leukemia, Plasma Cell/diagnosis*

Objective: To evaluate the prognostic value of Mayo MASS and R2-ISS staging systems in patients newly diagnosed with multiple myeloma (MM) . Methods: A total of 371 patients newly diagnosed with MM in Jiangsu Province Hospital were included in the study. Cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization (cIg-FISH) was performed to detect cytogenetic abnormality. Clinical characteristics were combined to analyze the disease stage and evaluate the prognosis. Results: There were 37 (10.0%), 264 (71.0%), and 70 (18.8%) patients in R-ISS stage Ⅰ, Ⅱ, and Ⅲ, respectively. The median progression-free survival (PFS) times were 37, 25, and 14 months (P<0.001). The median overall survival (OS) times were not reached (NR), 66, and 30 months (P<0.001). There were 71 (19.1%), 140 (37.7%), and 160 (43.2%) patients in Mayo MASS stages Ⅰ, Ⅱ, and Ⅲ, and the median PFS times periods were 43, 27, and 19 months (P<0.001), and the median OS times were NR, NR, 35 months, respectively (P<0.001). There were, 23 (6.2%), 69 (18.6%), 222 (59.8%), and 57 (15.4%) patients in R2-ISS stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. The median PFS times were 47, 31, 25, and 15 months (P=0.001), and the median OS times were NR, NR, 49, and 55 months, respectively (P<0.001) . Conclusion: Based on the R-ISS staging system, Mayo MASS, and R2-ISS prognostic staging system incorporated 1q21+, which allows a better stratification. However, the proportion of stage Ⅲ patients in Mayo MASS and R2-ISS staging systems is relatively high, which is considered related to the high incidence of 1q21+ and ISS Ⅲ in the Chinese population.
Humans ; Prognosis ; Multiple Myeloma/diagnosis* ; In Situ Hybridization, Fluorescence ; Neoplasm Staging ; Retrospective Studies

Humans ; Prognosis ; Multiple Myeloma/diagnosis* ; Neoplasm Staging ; Hematopoietic Stem Cell Transplantation ; Patients ; Retrospective Studies

OBJECTIVE: To analyze the effect of CD56 expression on the prognosis of newly diagnosed multiple myeloma (MM) patients and explore the relationship between CD56 with clinical characteristics. METHODS: In this retrospective study, the clinical data and laboratory parameters of 175 newly diagnosed MM patients from February 2015 to December 2020 in the Second Hospital of Anhui Medical University were collected. The patients were divided into CD56⁺ and CD56^- groups based on the expression of CD56, and the general data and laboratory parameters of the two groups were compared. The patients were followed up to June 30, 2021, and progression-free survival (PFS) and overall survival (OS) were recorded. PFS and OS curves of the two groups were plotted respectively, and the survival differences were compared. Univariate and multivariate Cox regression analyses were performed to analyze the effect of CD56 on the prognosis of newly diagnosed MM patients. RESULTS: In 175 newly diagnosed MM patients, 57(32.6%) cases were in the CD56^-group and 118 (67.4%) cases in the CD56⁺ group. There was significant correlation between CD56 expression and ISS stage, ECOG score, platelets, β₂-microglobulin, creatinine, and extramedullary disease (all P <0.05). The incidence of extramedullary disease in the CD56^- group was significantly higher than that in the CD56⁺ group (29.8% vs 12.7%, P =0.006). The median follow-up time of the whole cohort was 23.6 (1.0-78.6) months. The median PFS of patients in CD56⁺ group and CD56^- group were 18.6 (1.2-77.6) and 12.2 (1.0-49.0) months, respectively, and the median OS of the two groups were 27.6 (1.4-77.7) and 19.7 (1.0-78.6) months, respectively. The 2-year PFS rate in the CD56⁺ group was significantly higher than that in the CD56^- group (57.6% vs 36.8%, P =0.010), and the 2-year OS rate in the CD56⁺ group was higher than that in the CD56^- group, but it didn't reach statistical significance (74.6% vs 64.9%, P =0.158). The results of univariate Cox regression analysis showed that the PFS was significantly shorter in newly diagnosed MM patients with advanced age, type IgG, high ECOG score, decreased platelet count, increased lactate dehydrogenase level, extramedullary disease, and CD56^- (all P <0.05), the OS was significantly shorter in patients with high ECOG score, decreased platelet count, increased lactate dehydrogenase level, extramedullary disease, and CD56^- (all P <0.05). The results of multivariate Cox regression analysis showed that advanced age, type IgG, elevated lactate dehydrogenase level, extramedullary disease, and CD56^- were independent prognostic factors for poor PFS (all P <0.05); and decreased platelet count, elevated lactate dehydrogenase level, and extramedullary disease were independent adverse prognostic factors for OS (all P <0.05), while there was no significant independent correlation between CD56 and OS (P >0.05). CONCLUSION Most of the newly diagnosed MM patients have positive expression of CD56. Loss of CD56 expression was associated with unfavorable biological and clinical parameters and poor prognosis, suggesting that CD56 has important clinical value in the prognosis of newly diagnosed MM patients.
Humans ; Immunoglobulin G ; Lactate Dehydrogenases ; Multiple Myeloma/diagnosis* ; Prognosis ; Retrospective Studies

Humans ; Multiple Myeloma/genetics* ; Neoplasm, Residual/diagnosis* ; Flow Cytometry ; High-Throughput Nucleotide Sequencing