Liu M, Zhang JY. Reduction rate of monoclonal protein as a useful prognostic factor in standard-risk group of newly diagnosed multiple myeloma. World J Clin Cases 2023; 11(24): 5643-5652 [PMID: 37727707 DOI: 10.12998/wjcc.v11.i24.5643]
Corresponding Author of This Article
Jun-Yu Zhang, MM, Chief Doctor, Department of Hematology, Lishui Municipal Central Hospital, No. 289 Kuocang Road, Lishui 323000, Zhejiang Province, China. zhangjunyu815@163.com
Research Domain of This Article
Hematology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
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World J Clin Cases. Aug 26, 2023; 11(24): 5643-5652 Published online Aug 26, 2023. doi: 10.12998/wjcc.v11.i24.5643
Table 1 Baseline characteristics of multiple myeloma patients with a reduction rate of monoclonal protein after first and fourth cycles of chemotherapy
Characteristic
C1 reduction rate
P value
C4 reduction rate
P value
< 50
≥ 50
< 75
≥ 75
Age (yr)
≤ 0.001
0.003
< 65
25
56
21
60
≥ 65
49
34
40
43
Gender
0.912
0.903
Male
36
43
37
42
Female
38
47
39
46
ISS stage
≤ 0.001
≤ 0.001
I
5
39
2
42
II
31
34
23
42
III
38
17
36
19
DS stage
0.087
0.783
I
1
1
1
1
II
7
20
9
19
III
66
70
51
83
GPT
0.657
0.985
≤ 40
71
85
58
98
> 40
3
5
3
5
GOT
0.510
0.617
≤ 40
67
84
57
94
> 40
7
6
4
9
CRP
0.704
0.880
≤ 10
53
62
42
83
> 10
21
28
19
20
A/G
0.916
0.041
≤ 0.5
29
36
18
47
> 0.5
45
54
43
56
LDH
0.215
0.530
≤ 245
54
73
46
82
> 245
20
17
15
21
t(6;14)
3
3
1.000
2
4
0.405
t(11;14)
2
2
1.000
1
3
0.615
Platelet count
≤ 0.001
≤ 0.001
≥ 100
55
88
45
98
< 100
19
2
16
5
Herpes
13
19
0.569
9
23
Autotransplantation
5
20
0.006
5
20
0.020
TC (mmol/L)
0.903
0.767
< 5.2
63
76
52
86
≥ 5.2
11
14
9
17
TG (mmol/L)
0.546
0.778
< 1.71
51
58
41
67
≥ 1.71
23
32
20
36
P (mmol/L)
0.587
0.568
< 1.07
17
24
13
26
≥ 1.07
57
66
48
77
Table 2 Univariate analysis of progression-free survival and overall survival
Prognostic factor
PFS
OS
HR (95%CI)
P value
HR (95%CI)
P value
Age (yr)
1.051 (1.031-1.071)
≤ 0.001
1.034 (1.012-1.055)
0.002
Gender
1.265 (0.828-1.931)
0.277
1.412 (0.926-2.152)
0.109
Classification
1.037 (0.949-1.132)
1.037
1.093 (0.999-1.196)
0.053
ISS stage
1.718 (1.247-2.366)
0.001
2.093 (1.520-2.883)
≤ 0.001
DS stage
2.094 (1.082-4.054)
0.028
1.982 (1.015-3.869)
0.045
GPT
1.011 (1.002-1.021)
0.019
1.009 (0.999-1.019)
0.082
GOT
1.022 (1.011-1.033)
≤ 0.001
1.025 (1.013-1.038)
≤ 0.001
CRP
1.002 (0.996-1.007)
0.593
1.002 (0.996-1.008)
0.491
A/G
1.041 (0.698-1.553)
0.844
1.149 (0.754-1.751)
0.518
LDH
1.003 (1.001-1.004)
≤ 0.001
1.003 (1.002-1.005)
≤ 0.001
t(6;14)
1.021 (0.319-3.266)
0.972
1.285 (0.399-4.134)
0.674
t(11;14)
1.149 (0.281-4.708)
0.847
1.188 (0.290-4.871)
0.811
Platelet count
9.604 (4.965-18.578)
≤ 0.001
8.437 (4.528-15.721)
≤ 0.001
Herpes
0.821 (0.451-1.495)
0.52
0.908 (0.498-1.653)
0.751
Chemotherapy regimen
1.005 (0.856-1.180)
0.952
0.949 (0.795-1.133)
0.564
Autotransplantation
0.339 (0.137-0.842)
0.020
0.347 (0.140-0.860)
0.022
TC
0.773 (0.631-0.947)
0.013
0.757 (0.617-0.927)
0.007
TG
0.861 (0.666-1.114)
0.255
0.846 (0.642-1.113)
0.232
P
1.143 (0.953-1.370)
0.15
1.113 (0.934-1.325)
0.232
C1 reduction rate
0.412 (0.325-0.521)
≤ 0.001
0.438 (0.346-0.554)
≤ 0.001
C2 reduction rate
0.412 (0.325-0.523)
≤ 0.001
0.441 (0.351-0.553)
≤ 0.001
C3 reduction rate
0.390 (0.303-0.501)
≤ 0.001
0.377 (0.290-0.490)
≤ 0.001
C4 reduction rate
0.358 (0.283-0.455)
≤ 0.001
0.345 (0.267-0.445)
≤ 0.001
Table 3 Multivariate analysis of progression-free survival
Prognostic factor
HR (95%CI)
P value
Age
1.059 (1.033-1.085)
≤ 0.001
ISS stage
2.136 (1.500-3.041)
≤ 0.001
DS stage
1.622 (0.264-1.622)
0.264
GPT
1.017 (0.997-1.036)
0.097
GOT
1.002 (0.977-1.028)
0.857
LDH
1.000 (0.997-1.003)
0.944
Platelet count
1.880 (0.732-4.830)
0.189
Maintenance regimen
0.410 (0.236-0.710)
0.001
Autotransplantation
0.201 (0.069-0.583)
0.003
TC
0.689 (0.533-0.891)
0.005
C1 reduction rate
0.474 (0.293-0.767)
0.002
C2 reduction rate
0.792 (0.440-1.427)
0.438
C3 reduction rate
1.974 (0.921-4.230)
0.08
C4 reduction rate
0.254 (0.139-0.463)
≤ 0.001
Table 4 Multivariate analysis of overall survival
Prognostic factor
HR (95%CI)
P value
ISS stage
1.879 (1.315-2.686)
0.001
Age
1.054 (1.027-1.081)
0.024
DS stage
1.829 (0.791-4.233)
0.158
GOT
1.009 (0.988-1.031)
0.395
LDH
0.998 (0.996-1.001)
0.264
Platelet count
2.929 (1.269-6.756)
0.012
Autotransplantation
0.211 (0.069-0.647)
0.006
TC
0.735 (0.573-0.943)
0.016
C1 reduction rate
0.868 (0.543-1.387)
0.553
C2 reduction rate
0.680 (0.386-1.197)
0.181
C3 reduction rate
1.055 (0.592-1.879)
0.856
C4 reduction rate
0.608 (0.350-1.058)
Citation: Liu M, Zhang JY. Reduction rate of monoclonal protein as a useful prognostic factor in standard-risk group of newly diagnosed multiple myeloma. World J Clin Cases 2023; 11(24): 5643-5652