Prognostic Analysis Of Multiple Myeloma Based On Nomogram

Objective: To explore the key prognostic factors of multiple myeloma(MM)and establish an effective nomogram model to predict the survival rate of patients with multiple myeloma.Methods: The clinical data of 136 patients with multiple myeloma who were diagnosed in our hospital from February 2011 to October 2018 were selected for retrospective analysis,and the clinical characteristics,treatment plan,and overall survival(OS)of the patients were recorded.Follow-up until 2019 On October 20,the follow-up period was 1-104 months.Log-rank test is used for univariate prognosis analysis,and COX proportional hazard regression model is used for multivariate prognosis analysis.R software is used to establish a nomogram model for predicting MM risk,and the Bootstrap method is used for verification.The consistency index(C-index)evaluates the prediction efficiency of nomogram.The graph is based on the scores of the nomogram to establish the survival risk stratification,and the Kaplan-Meier method draws the survival curve.Results: The median age of the 136 patients was 56 years(29-83 years),87 cases were male(64.0%),49 cases were female(36.0%),and 72 cases died by the time of follow-up.Univariate analysis showed that hemoglobin(Hb),platelets(PLT),lactate dehydrogenase(LDH),uric acid(UA),corrected blood calcium(c Ca),serum β2microglobulin(β2-MG),ISS staging,Thalidomide or lenalidomide maintenance therapy(T or R),autologous hematopoietic stem cell transplantation(ASCT),complete response(CR)are the influencing factors of the overall survival time of patients(P<0.05).Multivariate prognostic analysis showed that Hb,LDH,c Ca,T or R,ASCT,CR were independent prognostic factors for the prognosis of MM(P<0.05).Establish a nomogram based on the results of multivariate regression to predict 1,3,and 5-year survival rates,with a C-index of 0.73(95%CI: 0.67-0.80).The predicted survival probability of the calibration curve for 1,3,and 5 years is basically the same as the actual survival probability.The probability is basically the same,reflecting that the model has a high degree of discrimination and consistency.According to the nomogram score,the survival risk is stratified and divided into high group and low group.The survival rate of patients in the high group is significantly lower than that of the low group.The OS has a significant difference(P=0.00008).Conclusion: The prognosis of MM is affected by many factors.Anemia,high lactate dehydrogenase,and hypercalcemia are adverse factors affecting the prognosis of patients at the first diagnosis,while thalidomide or lenalidomide maintenance therapy,autologous hematopoietic stem cell transplantation,the curative effect of CR is a protective factor that affects the prognosis.The nomogram based on the COX model can predict the survival rate of MM.This new model helps to evaluate the prognosis of MM patients in the era of new drug maintenance treatment,and provides a convenient and reliable predictive model for individualized treatment and clinical decision-making.