Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4234
Peer-review started: September 8, 2019
First decision: November 11, 2019
Revised: October 14, 2019
Accepted: November 27, 2019
Article in press: November 27, 2019
Published online: December 26, 2019
Processing time: 108 Days and 6.1 Hours
The guiding effect of prognostic stratification in multiple myeloma (MM) for treatment has been increasingly emphasized in recent years. The stratification of risk factors based on the International Staging System (ISS), Durie-Salmon (DS) staging and related indicators is affected by the renal function of patients, resulting in poor performance. This study assesses the relationship between interleukin-32 (IL-32) and related risk factors in 67 patients with MM and their clinical outcomes.
To investigate the feasibility of IL-32 in evaluating prognosis in patients with MM and the factors influencing prognosis.
This was a pragmatic, prospective observational study of patients with MM at a single center. According to IL-32 level, patients were divided into two groups. The variables under consideration included age, blood β2-microglobulin, albumin, C-reactive protein, serum calcium, serum creatinine, lactate dehydrogenase, M protein type, ISS stage, DS stage, and IL-32 levels and minimal residual disease (MRD) after induction treatment. The main outcomes were progression-free survival (PFS) and overall survival (OS).
IL-32 was an important factor affecting PFS and OS in patients with MM. Compared with patients with IL-32 levels ≥ 856.4 pg/mL, patients with IL-32 levels < 856.4 pg/mL had longer PFS (P = 0.0387) and OS (P = 0.0379); Univariate analysis showed that IL-32 level and MRD were significantly associated with OS and PFS (P < 0.05). Multivariate analysis showed that IL-32 levels ≥ 856.4 pg/mL and MRD positive were still independent risk factors for OS and PFS (P < 0.05).
IL-32 is valuable for assessing the prognosis of MM patients. IL-32 level combined with MRD may be a useful routine evaluation index for MM patients after treatment.
Core tip: Multiple myeloma (MM) is a heterogeneous disease with a survival time ranging from several months to 20 years, and its clinical manifestations are complex. There are many factors affecting the prognosis. The International Staging System and Durie-Salmon staging have been established to assess prognosis of the disease, but the accuracy of β2-microglobulin and albumin is controversial. In recent years, new prognostic indicators of MM are being continuously investigated. Studies have shown that renal function in association with the degree of bone destruction, and hypercalcemia, can determine the prognosis of MM and predict overall survival (OS). Moreover, minimal residual disease can also predict OS and progression-free survival in patients with MM. We collected data from MM patients in our hospital, analyzed their clinical efficacy, follow-up results and laboratory examination indicators, which suggested that interleukin-32 can be used as an auxiliary indicator for post-treatment efficacy and prognosis assessment.