全新风险分层模型R2-ISS对初诊多发性骨髓瘤的预后评估价值

Prognostic Value of A New Risk Stratification Model(R2-ISS)in Newly Diagnosed Multiple Myeloma

目的:探讨全新风险分层模型R2-ISS在评估初诊多发性骨髓瘤(MM)患者预后中的意义。方法:回顾性分析2012年6月至2021年3月兰州大学第二医院收治的116例初诊MM患者临床资料,按R2-ISS将患者分为低危、中低危、中高危和高危共4组,分析R2-ISS对初诊MM患者预后的影响。结果:生存分析结果显示,R2-ISS与患者无进展生存期(P=0.042)及总生存期(P=0.014)相关。Cox单因素分析结果显示,乳酸脱氢酶、血钙、血肌酐、β_(2)-微球蛋白、ISS、R-ISS、R2-ISS、t(4;14)、自体造血干细胞移植(ASCT)是初诊MM患者总生存期的影响因素(均P<0.05)。Cox多因素分析结果显示,R-ISS、R2-ISS及ASCT是影响患者总生存期的独立危险因素(均P<0.05)。此外,对不同R2-ISS患者的生存分析结果显示,ASCT改善了患者的无进展生存期、总生存期(均P<0.05)。结论:R2-ISS对初诊MM患者具有预后判断价值,ASCT可改善不同R2-ISS患者的生存预后。

Objective:To investigate the significance of a new risk stratification model(R2-ISS)in evaluating the prognosis of newly diagnosed multiple myeloma(MM).Methods:Clinical data of 116 newly diagnosed MM patients admitted to Lanzhou University Second Hospital from June 2012 to March 2021 were retrospectively analyzed.According to R2-ISS,these patients were divided into four groups:low risk,low-intermediate risk,intermediate-high risk,and high risk.The significance of R2-ISS on prognosis of the patients was analyzed.Results:Survival analysis showed that R2-ISS was associated with progression-free survival(PFS)(P=0.042)and overall survival(OS)(P=0.014).Cox univariate analysis showed that lactate dehydrogenase,serum calcium,serum creatinine,β_(2)-microglobulin,ISS,R-ISS,R2-ISS,t(4;14),and autologous hematopoietic stem cell transplantation(ASCT)were the influencing factors of OS in newly diagnosed MM patients(all P<0.05).Cox multivariate analysis showed that R-ISS,R2-ISS,and ASCT were independent risk factors affecting OS(all P<0.05).In addition,survival analysis of patients with different R2-ISS showed that ASCT improved PFS and OS.Conclusion:R2-ISS has prognostic value for newly diagnosed MM patients,while ASCT can improve the prognosis of patients with different R2-ISS.