Department of Hematology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Department of Hematology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
Clin Lymphoma Myeloma Leuk. 2020 Oct;20(10):704-711. doi: 10.1016/j.clml.2020.05.013. Epub 2020 May 26.
Socioeconomic status (SES) has been shown to be a prognostic factor for overall survival in a variety of hematologic malignancies, especially for patients who require continuous care such as those with multiple myeloma (MM).
We retrospectively collected data from 223 patients with symptomatic MM diagnosed and treated in our department from January 2005 to December 2019. The modified Kuppuswamy scale, slightly modified, was used for the SES assessment. The Kaplan-Meier estimator of survival and Cox regression analysis were used.
In our cohort of 223 patients with MM, low SES was an independent poor prognostic factor for overall survival (OS), in addition to higher International Staging System stage and high-risk cytogenetics (hazard ratio for low SES on Cox regression analysis, 2.092; 95% confidence interval [CI], 1.36-3.2; log-rank P = .000). Patients with low SES had inferior survival compared with the whole patient cohort (median OS: low SES, 28 months; 95% CI, 18-37.9; high SES, 68 months; 95% CI, 55.6-80.4; log-rank P = .000). The low SES effect on OS was more evident for the elderly patients who were not transplant eligible and in those with a diagnosis of MM International Staging System stage I. The effect of low SES on OS was attenuated by time, and ethnic origin had no effect on OS.
The results of the present study have shown that low SES is an independent poor prognostic factor for survival of patients with MM.
社会经济地位(SES)已被证明是多种血液系统恶性肿瘤总生存的预后因素,特别是对于需要持续护理的患者,如多发性骨髓瘤(MM)患者。
我们回顾性地收集了 2005 年 1 月至 2019 年 12 月在我科诊断和治疗的 223 例有症状 MM 患者的数据。采用改良的 Kuppuswamy 量表进行 SES 评估,该量表稍作修改。采用 Kaplan-Meier 生存估计和 Cox 回归分析。
在我们的 223 例 MM 患者队列中,低 SES 是总生存(OS)的独立不良预后因素,除了较高的国际分期系统(ISS)分期和高危细胞遗传学外(Cox 回归分析中低 SES 的风险比,2.092;95%置信区间[CI],1.36-3.2;对数秩 P =.000)。与整个患者队列相比,SES 较低的患者生存较差(中位 OS:低 SES,28 个月;95%CI,18-37.9;高 SES,68 个月;95%CI,55.6-80.4;对数秩 P =.000)。低 SES 对 OS 的影响在不适合移植的老年患者和诊断为 ISS 分期 I 的 MM 患者中更为明显。低 SES 对 OS 的影响随时间减弱,而种族对 OS 没有影响。
本研究结果表明,低 SES 是 MM 患者生存的独立不良预后因素。