Reduction rate of monoclonal protein as a useful prognostic factor in standard-risk group of newly diagnosed multiple myeloma

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

C1: The first cycle; C4: The fourth cycle; ISS: International Staging System; DS: Durie-Salmon; GPT: Glutamic-pyruvic transaminase; GOT: Glutamic-oxaloacetic transaminase; CRP: Catabolite activator protein; A/G: Albumin/globulin; LDH: Lactate dehydrogenase; T: Translocation; TC: Total cholesterol; TG: Triglyceride; P: Phosphorous.

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

PFS: Progression-free survival; OS: Overall survival; HR: Hazard Ratio; 95%CI: 95% confidence interval; ISS: International Staging System; DS: Durie-Salmon; GPT: Glutamic-pyruvic transaminase; GOT: Glutamic-oxaloacetic transaminase; CRP: Catabolite activator protein; A/G: Albumin/globulin; LDH: Lactate dehydrogenase; T: translocation; TC: Total cholesterol; TG: Triglyceride; P: Phosphorous; C1: The first cycle; C2: The second cycle; C3: The third cycle; C4: The fourth cycle.

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

HR: Hazard ratio; 95%CI: 95% confidence interval; ISS: International Staging System; DS: Durie-Salmon; GPT: Glutamic-pyruvic transaminase; GOT: Glutamic-oxaloacetic transaminase; LDH: Lactate dehydrogenase; TC: Total cholesterol; C1: The first cycle; C2: The second cycle; C3: The third cycle; C4: The fourth cycle.

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)

HR: Hazard ratio; 95%CI: 95% confidence interval; ISS: International Staging System; DS: Durie-Salmon; GOT: Glutamic-oxaloacetic transaminase; LDH: Lactate dehydrogenase; TC: Total cholesterol; C1: The first cycle; C2: The second cycle; C3: The third cycle; C4: The fourth cycle.