| ObjectiveTo explore the impact of minimal residual disease by flow cytometry and high-risk cytogenetic characteristics on the prognosis of multiple myeloma patients in the real world.MethodsNinety-one newly diagnosed patients with multiple myeloma(NDMM)were analyzed retrospectively from January 1,2015 to December 31,2018.The MM patients included in the study all met the diagnostic criteria of multiple myeloma updated by the International Myeloma Working Group in 2014.After receiving bortezomib or lenalidomide-based induction therapy,bone marrow samples of the patients who achieved a very good partial remission(VGPR)or better,were evaluated again by flow cytometry for minimal residual disease(MRD)and cytogenetics by fluorescence in situ hybridization(FISH).The NDMM patients were grouped and compared according to minimal residual disease by flow cytometry after treatment,the cytogenetic characteristics by FISH of the patient’s initial diagnosis and other clinical data.We utilized SPSS 18.0 software for statistical analysis to compare the clinical characteristics,efficacy evaluation,survival time between each group,P <0.05 was considered statistically significant.Results1.A total of 91 MM patients with complete information was included in the study.After treatment,27/91 patients(29.7%)were MRD-negative and 64/91 patients(70.3%)were MRD-positive.There was no statistically significant difference between the two groups of patients in terms of gender,age,cytogenetics,DS stage,ISS stage and R-ISS stage,and hemoglobin,lactate dehydrogenase,serum calcium concentration(P> 0.05).2.The NDMM patients were divided into two groups according to cytogenetics: highrisk cytogenetics(HRC)and standard-risk cytogenetics(SRC),41(45.1%)in SRC group and 50(54.9%)in HRC group.There were no statistical differences in age,gender,hemoglobin concentration,lactate dehydrogenase concentration,serum Ca concentration,DS stage,ISS stage and R-ISS stage between the two groups(P> 0.05).3.The overall median follow-up was 27(4.2-60)months,of which the MRD negative group and the MRD positive group were 27 months and 22 months,respectively.The median PFS of the MRD negative group and the MRD positive group were 31 and 23.8 months,respectively,and the difference between the two groups was statistically significant(P <0.05).The 1-year OS rate in the MRD negative group and the MRD positive group was 93% and 86%.There was no statistical difference in the median OS between the two groups(χ2 = 2.769,P = 0.096).4.The median follow-up was 28.2 months in the SRC group and 35.5 months in the HRC group.The median PFS of the SRC group and HCR group were 30.1 and 24.7 months,respectively(P = 0.007).The 1-year OS rate of SRC group and HRC group is divided into 100% and 98%.The median OS of the two groups was not statistically significant(χ2 = 0.909,P = 0.34).5.Patients with MRD negative and SRC group achieved the best median PFS,with a median PFS of 36 months,which is statistically significant compared with other groups(P <0.05);The median PFS of MRD negative and HRC group,MRD positive and SRC,MRD positive and HRC group were(27.9vs28.2vs23.4)months;There was no statistically significant difference in prognosis between MRD negative and HRC group and MRD positive SRC group(P> 0.05);The median PFS of MRD positive and HRC group was worse than MRD negative and SRC group,MRD negative and HRC group,the difference was statistically significant(P <0.05),but there was no statistical difference with MRD positive and SRC group(P> 0.05).Conclusion 1.Flow MRD-negative NDMM patients can obtain better PFS than Flow MRD-positive patients.2.NDMM patients with high-risk cytogenetics have worse PFS than those with standard cytogenetics.3.Flow MRD negative and high-risk cytogenetics are independent prognostic factors for NDMM patients. |
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