The role of prognostic factors in overall survival in patients with Bence-Jones multiple myeloma - our experience

Abstract

Introduction. Bence-Jones myeloma multiplex is a progressive disease characterized by excessive numbers of abnormal plasma cells in the bone marrow and overproduction of incomplete immunoglobulins, containing only the light chain portion of the immunoglobulins. This type of myeloma occurs 15-20%. The median overall survival is approximately 4 years. Aim of this study was to define prognostic factors affecting overall survival in Bence-Jones multiple myeloma patients. Material and Methods. From 1995 to 2015, we treated 75 patients (49 men and 26 female), average age 55.9 years (range 31-85). Results. Conventional chemotherapy introductory clinical response was achieved in 54 patients (72%), while in 21 patients (28%) the established disease was resistant. Transplantation was done in 45 patients (60%), while 30 patients (40%) were treated with conventional chemotherapy. In the group of patients with transplantation done, tandem was carried out in 11 patients and secondary stem cell transplantation was done in 5 relapsed patients. With 1 patient with tandem stem cell transplantation allogenic (singen) stem cell transplantation was done. Transplant related mortality is 1.5%. The transplanted patients had significantly longer PFS (mediana 13 months vs 7 months, p<0,05) and longer overal survival (mediana 55 months vs 26 months, p<0,001). Univariate log regression analysis showed that non-transplant patients are 5,1 times more likely to terminate lethal compared to transplant patients (RR 5,1; 95% C.I.43,47-2,52), p<0,001). Conclusion. Our study showed autologous stem cell transplantation is a more effective method of treatment of patients with Bence-Jones myeloma compared to the conventional chemotherapy.