基于24个月内疾病进展的多发性骨髓瘤患者预后模型的建立及临床应用

Establishment and clinical applications of a prognostic model based on diseaseprogression within 24 months in patients with multiple myeloma

  • 摘要:
    目的 基于24个月内疾病进展(disease progression within 24 months,POD24)建立多发性骨髓瘤(multiple myeloma,MM)的预后模型并探索其临床意义。
    方法 选取2007年1月至2022年6月无锡市人民医院289例初诊MM患者作为训练组进行回顾性分析,通过对总生存期(overall survival,OS)进行Cox单因素及多因素分析,构建以POD24为基础的预后模型;并收集2015年8月至2019年12月苏州大学附属第一医院184例患者作为验证队列验证该模型的预测效能。
    结果 POD24组患者OS更短,年龄、β2微球蛋白、血清钙以及POD24是MM的独立预后因素,高危组(≥2分)的患者较低危组(<2分),OS(25.0个月 vs. 60.0个月)及无进展生存期(progression-free survival,PFS)(14.0个月 vs. 56.0个月)更短。且在验证队列总体患者及各亚组的患者中高危组和低危组间的OS、PFS比较,差异均无统计学意义(均P<0.05)。
    结论 基于POD24、年龄、β2微球蛋白、血清钙构建的预后模型在真实世界中对初诊MM患者具有预后价值。

     

    Abstract:
    Objective To establish a prognostic model and explore its clinical application based on disease progression within 24 months (POD24) in patients with multiple myeloma (MM).
    Methods A total of 289 patients newly diagnosed with MM at Wuxi People's Hospital from January 2007 to June 2022 were selected as the training group for retrospective analysis. A prognostic model based on POD24 was constructed using Cox univariate and multivariate analyses of overall survival (OS). A total of 184 patients from The First Affiliated Hospital of Soochow University from August 2015 to December 2019 were included in the validation group to verify the predictive efficacy of the model.
    Results Age, β2-microglobulin, Calcium, and POD24 were independent prognostic factors for MM. Patients in the high-risk group (≥2 points) had shorter OS (25.0 months vs. 60.0 months) and progression-free survival (PFS)(14.0 months vs. 56.0 months) than those in the low-risk group (<2 points). In addition, OS and PFS differed between the high- and low-risk groups in the entire validation group, as well as in each patient subgroup (P<0.05).
    Conclusions The prognostic model based on POD24, age, β2 microglobulin, and Calcium holds prognostic value for patients newly diagnosed with MM in clinical practice.

     

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