The Comparation Of Different Clinical Staging Systems For Multiple Myeloma: A Retrospective Analysis Of 117 Cases

[Background]:Multiple myeloma is a malignancy characterized by a proliferation of clonal plasma cells that usually produce a monoclonal protein.Its incidence accounts for 1% that of malignant tumors, and more than 10% that of hematologic cancers.A reasonable MM staging system is critical to the evalation of the conditions, curative effect and prognosis of patients. The DS system has long been used as a gold standard of MM staging till present day. It was proposed by Durie et al based on the analysis of the correlation of osteolytic damage ,hemoglobin concentration, the level of blood/urine protein M ,the level of serum calcium ion and serum creatinine with the number of myeloma cells, survival time , and response to therapy in MM patients. It was not until 2005 that the ISS staging based on serumβ2 microglobulin and albumin level came into being .The staging was proposed by researchers like Greipp etc. from institutes in North America,Asia,and Europe who gathered clinical data of 10750 patients primary diagnosed as MM.It was soon widely acknoleged because of its simplicity for retention and well-distributed sample sizes over different stages. Few documents are found internal to have reported on the correlation between the two staging systems,how the relevant prognostic indices are related to the systems ,and the survival time comparison between them.This paper analyzed retrospectively the 117 patients primary diagnosed as MM in admission to China-Japan Union Hospital of Jilin University from January 2000 to January 2008 in order to compare the consistency of the two systems, the correlaton of prognostic indices with the systems and the survival time with them.[Materials and Methods]:213 patients primary diagnosed as MM in admission to China-Japan Union Hospital of Jilin University from January 2000 to January 2008 were chosen. The medical data of 117 patients who could be staged according to the two systems were processed into EXCEL and analyzed with statistical software SPSS 13.0. P<0.05 is considered to have statistical significance while P<0.01 notable statistical significance.[Results]:1. DS staging is weakly correlated with ISS staging.2.β2 microglobulin ,albumin level ,serum creatinine, corrected serum calcium concentration , hemoglobin concentration and percentage of plasma cells in bone marrow showed correlation with DS staging ( P < 0.05 ) ,while the correlation ofβ2 microglobulin and albumin level,corrected serum calcium concentration , serum creatinine,and hemoglobin concentration with ISS staging displayed statistical significance .3.β2 microglobulin is significant statistically correalted with serum creatinine,while albumin showed statistical correlation with age,corrected serum calcium concentration, the level of lactate dehydrogenase,platelet count and hemoglobin.4. In DS system, the level of serum albumin, corrected serum calcium concentration , hemoglobulin, and the percentage of plasma cells in bone marrow tend to be graded over the three stages (P<0.05), yet microglobulin and serum creatinine displayed no statistical gradation(P>0.05).5. In ISS system, the differences ofβ2 microglobulin, serum albumin level, serum creatinine, and hemoglobin among the three stages were statistically significant( P<0.05), while corrected serum calcium concentration showed no statistical significance among the stages(P>0.05)6. In DS system,survival time between stageⅡandⅢshowed statistically significant(P=0.005),which between stageⅠandⅡ, stageⅠandⅢshowed no statistical significance.In ISS system,the survival duration showed statistically significant between stageⅠandⅡ,ⅡandⅢ,ⅠandⅢ.[Conlusion]:ISS staging and DS staging have weak consistency.Compared to ISS staging system,DS staging showed no significant superiority, while,the prognostic related to ISS systems is confirmed concise for retention and easy for generalization.The prognosis efficiency is better in ISS staging system.