Haematopoietic Score for the Prognostic Evaluation of Multiple Myeloma Patients Undergoing First-line Treatment With a Bortezomib-based Regimen

Abstract

Backgroud: It is very important to evaluate the prognosis of multiple myeloma (MM) patients before starting treatment. Although haematopoietic status may have a significant impact on patient survival, it has not received sufficient attention in current clinical practice.Methods:This was a retrospective study of 150 newly diagnosed MM patients treated in one hematonosis treatment centre from May 2013 to June 2016, all of whom received first-line treatment with a bortezomib-based regimen.The effects of haematopoietic factors, including haemoglobin levels (Hgb <100 g/L), mean corpuscular volume (MCV>99.1 fL), and platelet count (<150 × 10E9/L), on the prognosis of the patients were analysed. Each of the above factors was assigned a value of 1 to generate a haematopoietic score.Results: According to the results, 59 (39.3%) patients had a score of 0, 43 (28.7%) had a score of 1, 29 (19.3%) had a score of 2, and 19 (12.7%) had a score of 3. The median PFS times were 43.1, 24.5, 32.6 and 14.2 months, respectively (P<0.001), and the median OS times were NR, 47.1 months, NR and 31.4 months, respectively (P<0.001). Multivariable analysis showed that the R-ISS stage (3 vs 1-2, HR, 1.4), haematopoietic score (3 vs 0-2, HR, 1.91) and plasma cell percentage (>30%, HR, 1.96) are independent prognostic predictors for PFS; age (≤65 years, HR, 0.54), the Durie-Salmon stage (3B vs 1-3a, HR, 2.96), haematopoietic score (3 vs 0-2, HR, 2.53) and the bone marrow plasma cell percentage (>30%, HR, 2.35) are independent prognostic predictors of OS. Conclusion: This study suggests that the haematopoietic score can be used to evaluate the prognosis of newly treated MM patients in the era of new drugs. However, there is still a need to enlarge the number of cases and carry out prospective research to validate this conclusion.