Correlation Analysis Of Clinical Features And Efficacy In 98 Patients With Multiple Myeloma

Objective:In this study,we retrospectively analyzed the clinical features of 98 patients with newly diagnosed multiple myeloma(MM).Our aim is to find the correlation between changes in certain clinical characteristics and curative effect,and to provide a theoretical reference for prognostic judgment and optimal treatment of MM patients.Methods:The clinical data of 98 newly diagnosed MM patients admitted to our hospital from June 2017 to June 2020 were retrospectively analyzed.All cases met the diagnostic criteria of the Chinese Guidelines for the Diagnosis and Treatment of Multiple Myeloma(revised in 2020).Clinical data included gender,age,hemoglobin level,serum calcium level,albumin level,creatinine level,β2-microglobulin level,immunoglobulin electrophoresis level,lactate dehydrogenase level,disease stage,cytogenetic changes(FISH detection method)and treatment plan.We analyzed the difference of curative effect of different chemotherapy regiments(bortezomib and bortezomib without)for MM patients after completing 4 courses of regular chemotherapy.We also analyzed the correlation between cytogenetic changes and clinical manifestations and efficacy of MM patients.SPSS 26.0 statistical software was used to process the data,and P<0.05 was considered statistically significant.Results:(1)FISH was performed in 77 of 98 MM patients,and the detection rate was78.57%(77 / 98).Among the 77 patients examined,43 patients had different cytogenetic changes,and the abnormal detection rate was 55.84%(43 / 77).(2)Cytogenetic changes were as follows: The detection rate of chromosome14 abnormality(IGH rearrangement)was 45.46%(35/77).Chromosome 13abnormality(13q14 deletion),with a positive rate of 27.27%(21/77).Chromosome 1 was abnormal(1q21 amplification),and the detection rate was35.07%(27/77).Chromosome 17 abnormality(TP53 deletion)was detected in 5.20%(4/77).(3)The serum calcium levels of patients with 1q21 amplification,and 13q14 deletion were higher than the patients who without 1q21 amplification,and 13q14 deletion,and the differences were statistically significant(P=0.023,P=0.009).In addition,patients with 1q21 amplification have more ISS Ⅲstages,higher β2-MG levels,and lower serum albumin levels than patients without 1q21 amplification.The differences were statistically significant(P = 0.017,P= 0.015,P = 0.007).(4)Of the 98 patients,56 cases received bortezomib containing regimen and 42 cases received bortezomib without regimen.After 4 courses of treatment,the efficacy was evaluated.The objective response rate of the treatment group with bortezomib was 76.79%,which was better than that of the treatment group without bortezomib(57.14%).The difference was statistically significant(P= 0.039).(5)43 patients with cytogenetic changes were evaluated for efficacy after completing 4 courses of treatment(regardless of whether they contained bortezomib drug treatment).Among them,23 cases achieved remission,with an objective response rate of 53.49%(23/43)).While 34 patients without cytogenetic changes were evaluated for efficacy after completing 4 courses of treatment,29 cases of them achieved remission,and the objective response rate was 85.29%(29/34).The difference between the two groups was statistically significant(P=0.006).(6)In 17 cases of MM patients with 1q21 amplification,9 cases achieved remission after 4 courses of bortezomib treatment,with an objective response rate of 52.94%(9/17).While among 30 cases without 1q21 amplification,27 cases achieved remission after 4 courses of bortezomib treatment,with an objective response rate of 90.00%(27/30).The difference in efficacy between the two groups was statistically significant(P=0.012).(7)In 13 MM patients with 13q14 deletion,9 patients achieved remission after 4 courses of treatment with bortezomib,with an objective response rate of 69.23%(9/13).34 MM patients without 13q14 deletion after 4 courses of treatment with bortezomib,27 cases achieved remission,with an objective response rate of 79.41%(27/34).There was no statistically significant difference between the two groups(P=0.725).Conclusion:(1)The cytogenetic abnormalities of MM patients are mostly manifested as IGH rearrangement,13q14 deletion,and 1q21 amplification.(2)The clinical features of MM patients are mostly related to cytogenetic abnormalities.(3)Patients with cytogenetic abnormalities usually have a poor prognosis.(4)The treatment plan with bortezomib is better than the treatment plan without bortezomib.(5)For MM patients with 1q21 amplification,the effect of bortezomib is unsatisfactory,the new therapeutic drugs can be considered.(6)This study is a retrospective study with a small sample size,and have certain limitations.