Genetic characteristics and prognostic influencing factors of middle-high-risk multiple myeloma patients stratified based on Mayo Stratification of Myeloma and Risk-Adapted Therapy consensus guidelines

Abstract

Objective To investigate the genetic characteristics and prognostic influencing factors of the middle-high-risk patients with multiple myeloma (MM) based on Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines. Methods A total of 179 hospitalized MM patients in Fujian Provincial Hospital from June 2009 to October 2017 were collected. Eventually, 49 patients were included except for the patients who were unable to perform mSMART stratification. According to the mSMART stratification criteria, the patients were divided into low-risk group (24 cases) and middle-high-risk group (25 cases). The genetic characteristics of the two groups were analyzed to explore the relationship between mSMART stratification and clinical features. Kaplan-Meier method and log-rank test were used to make survival analysis; logistic regression analysis was used to analyze the prognostic influencing factors in high-risk patients. Results The incidence of CSK1B gene amplification was the highest in the low-risk group (41.7%, 10/24), while in the middle-high-risk group, the incidence of RB1 gene deletion was the highest (88.0%, 22/25). In the low-risk group and the middle-high-risk group, there were no statistical differences in bone destruction, hypercalcemia, renal damage, anemia, β2 microglobulin abnormality, albumin abnormality, lactate dehydrogenase abnormality, and plasma cell ratio abnormality (all P > 0.05). Survival analysis showed that the median survival time of the middle-high-risk group was lower than that of the low-risk group (23.19 months vs. 39.71 months, P = 0.043). Multivariate logistic regression analysis found that anemia and bone destruction were risk prognostic influencing factors for mSMART stratification as a middle-high-risk group (P = 0.044, P = 0.002). Conclusion mSMART stratification could indicate the poor prognosis for the patients with middle-high-risk, and the anemia and bone destruction are risk prognostic influencing factors for patients with middle-high-risk stratification. Key words: Multiple myeloma; Mayo Stratification of Myeloma and Risk-Adapted Therapy; Prognosis; Cytogenetic abnormalities