Clinical Characteristics And Efficacy Analysis Of Newly Diagnosed Multiple Myeloma Patients Complicated With Light Chain Amyloidosis

Objective:The clinical characteristics and therapeutic effects of newly diagnosed symptomatic multiple myeloma(MM)patients complicated with light chain amyloidosis(AL)were analyzed.Methods:The clinical data of newly diagnosed multiple myeloma patients admitted to the First Affiliated Hospital of Suzhou University from January 1,2017 to October 31,2018 were collected and divided into two groups according to the pathological biopsy results of the patients,namely multiple myeloma group combined with AL light chain amyloidosis(MM+AL)and simple multiple myeloma(MM)group.The clinical characteristics and curative effects of the two groups were retrospectively analyzed and compared.Results:1.A total of 160 cases were included in this study,of which 42 cases were in MM+AL group(positive rate 26.5%).2.Amyloid protein deposition has no correlation with patient’s typing,clinical stage,heavy or light chain type,hemoglobin,albumin,creatinine,blood calcium,lactate dehydrogenase,24h urine protein,NT-proBNP and β2-MG.3.The differences between affected light chain and non-affected light chain(dFLC)was significantly higher in MM+AL group than in MM group(P<0.05).4.After induction,MM+AL group had higher total remission rate(ORR)(85.7%VS 79.7%,P<0.05)and higher very good partial remission rate(VGPR)(76.2%VS 55.1%,P<0.05)than MM group.5.the median PFS of patients in MM+AL group was 26 months,while that in MM group was 32 months(P>0.05).The median OS was not reached in both groups,(P>0.05).6.PFS and OS have no difference in accepting autologous stem cell transplantation between the two groups(P>0.05).However,compared with the patients in the non-transplanted group,autologous stem cell transplantation can improve OS in both groups(P=0.0009).In ISS stage III and R-ISS stage III,the median PFS and OS of the two groups were not statistically different(P>0.05).7.The prognosis of patients with cardiac involvement in MM+AL group is significantly worse than that of patients with MM group and patients without cardiac involvement in MM+AL group(P<0.0001).Conclusions:Patients in MM+AL group are easier to relieve than patients in MM group after induction,autologous stem cell transplantation can improve the prognosis of the two groups of patients.Patients in MM+AL group with cardiac involvement have the worst prognosis.