Relationship between first-line treatment response and bone marrow fibrosis in newly diagnosed multiple myeloma

Abstract

Objectives: Multiple myeloma (MM) occurs with uncontrolled and clonal increase proliferation of plasma cells in the bone marrow. Myelofibrosis can be primary or can be secondary when associated with other malignant or non-malignant diseases. MM is a malignant disease in which both collagen and reticulin fibrosis can be detected together at the time of diagnosis.The aim of this study is to investigate the relationship between bone marrow fibrosis at diagnosis and response to after first-line treatment in newly diagnosed MM. Material and Methods: In this study, 95 newly diagnosed MM patients were analyzed retrospectively. Demographic characteristics, complete blood count, biochemical examinations, bone marrow fibrosis grades, and first-line treatment response of the patients were retrieved from records as it is a retrospective study. Patients were divided into 2 groups according to their response to first- line treatment. Patients who have a strict complete response (sCR), complete response (CR) or a very good partial response (VGPR) responses to first-line therapy were included in the first group. Patients who gave partial response (PR), minimal response (MR) or progressive disease (PD) responses to the first-line therapy were included in the second group. Results: There were 72 patients in the Group I (good response group) and 23 patients in Group II (poor response group). Between the good response group and poor response group myeloma type, platelet count at diagnosis, β2 microglobulin, lactate dehydrogenase, erythrocyte sedimentation rate, bone marrow plasma cell ratio, R-ISS, and first-line treatment were not statistically significant (P > 0.05 ). Age was statistically significantly lower in the good response group (P = 0.04). In male gender, a better response was obtained (P = 0.02). At the time of diagnosis, hemoglobin levels in the good response group were found high compared to the poor response group (P = 0.02). Bone marrow fibrosis was found to be lower at the time of diagnosis in the group that responded good response to first-line treatment (P = 0.01). Conclusion: In this study, it was shown that bone marrow fibrosis at diagnosis is an important factor affecting the response to first-line treatment.The degree of bone marrow fibrosis detected at the time of diagnosis in MM may guide the selection of targeted therapy in first-line treatment.