Establishment Of Prediction Model For Disease Progression In Newly Diagnosed Multiple Myeloma Patients Within One Year

Purpose:Multiple myeloma(MM)is a malignant proliferative disease of plasma cells.The incidence rate of hematological malignancies is second,and it is still not cured.In the past decade,with the continuous research of targeted drugs,immunotherapy and the maturity of stem cell transplantation technology,the quality of life of patients has been significantly improved and the progression free survival of patients has been prolonged,but some patients still progress in the early stage of the disease.Early progression will affect the quality of life of patients and increase their economic burden.Some studies have proved that plasma cell labeling index and cytogenetics are risk factors for early progression of MM,but no study has analyzed the correlation between clinical laboratory indicators and disease progression within one year.The purpose of this study is to analyze the relevant indicators of newly diagnosed multiple myeloma(NDMM)patients,to obtain the relevant factors of disease progression in MM patients within one year,and to complete the establishment of prediction model.Methods:One hundred and eight MM patients treated in our hospital from January 2012 to January 2020 were retrospectively analyzed.First,the data were collected,and then the logistic univariate and multivariate regression analysis were used to get the related factors of MM patients’ progression within one year,and the prediction model was established.Results:1.Univariate logistic regression analysis showed that the therapeutic regimen containing targeted drugs was the protective factor for the progression of MM patients within one year,and the increased plasma cell ratio,lactate dehydrogenase,β2-microglobulin,serum corrected calcium,creatinine,and the ratio of neutrophil count to lymphocyte count were the risk factors for the progression of MM patients within one year;2.Multivariate logistic regression analysis showed that the treatment regimen containing targeted drugs(OR=0.140,95%CI 0.034-0.586)was the protective factor of disease progression within one year,and the increased lactate dehydrogenase(OR=4.886,95%CI 1.265-18.868)and serum corrected calcium(OR=4.513,95%CI 1.315-15.487)were the risk factors of disease progression within one year;3.According to binary Logistic regression principle,The regression equation of disease progression in MM patients within one year was obtained:x=-2.213-1.965 × treatment regimen(including targeted drug assignment as 1,otherwise 0)+1.586 × lactate dehydrogenase(U/L,lactate dehydrogenase elevation assignment as 1,normal as 0)+1.507 × serum corrected calcium(mmol/L,serum corrected calcium elevation assignment as 1,normal as 0).Through receiver operating characteristic(ROC)curve analysis,the model has good prediction performance.Conclusion:The increase of lactate dehydrogenase level and serum corrected calcium will increase the risk of MM disease progression;The treatment regimen containing targeted drugs will reduce the risk of MM disease progression;For NDMM patients,the disease progression within one year can be predicted by prediction model.For patients with X≥-2.4025,it indicates that MM patients are more likely to have disease progression within one year.The model can be used as a reference for clinicians to make individualized treatment plan for patients,so that patients can get better treatment effect.