[Prognostic evaluation in multiple myeloma. Relationship between immunological types, single prognostic factors, clinical staging systems, morphological classification systems and survival].

The prognostic value of the multiple myeloma (MM) immunological type, of 20 different single prognostic variables, of 11 clinical staging systems, and of 6 morphological classification systems was evaluated in 121 patients (71 males and 50 females, 75 MM IgG, 26 MM IgA, and 20 MM micromolecular), who were followed from diagnosis to demise. The values of the prognostic variables related to diagnosis were correlated with survival by means of univariate analysis; multivariate analysis according to Cox's model was employed to select highly-significant parameters correlated with survival among these variables. Every patient was retrospectively staged according to each clinical and morphological system. Mean survivals were computed for each group on the basis of immunological type, mean value of each prognostic factor, clinical and morphological stage. Survival curves were computed and compared. All prognostic parameters showed a significant relationship with survival, even though p-value differed. Multivariate analysis according to Cox's model has indicated the following variables as significantly correlated with survival: bone marrow plasma cell percentage, degree of lytic bone lesions, hemoglobinemia value, and serum levels of beta 2-microglobulin. Each clinical and morphological staging system, as well as immunological types and mean value of single prognostic parameters, have divided patients into separate groups with significant differences in mean survival and in survival curves. All of these factors could be taken into account for correct prognostic evaluation, and, if they were applied in different steps of diagnosis and therapy, it would be possible to study the MM patient under different perspectives, in order to have a more complete picture of the disease and of the patient.