[Effect of rFLC and dFLC on Clinical Prognosis of Patients with Newly Diagnosed Multiple Myelome and Best Cutoff Value].

OBJECTIVE

To investigate the influence of rFLC and dFLC on clinical prognosis and best cutoff value in patients with newly diagnosed multiple myelome(MM).

METHODS

Clinical data of 240 patients with newly diagnosed MM treated in Western Theater General Hospital of People's Liberation Army from January 2010 to June 2016 were collected and retroanalyzed. All patients were divided into different groups according to the interquartile spacing levels of rFLC and dFLC, the median OS and PFS of patients in different groups were compared. The influencing factors of prognosis in newly diagnosed MM patients were analyzed by univariate and multivariate methods, the influence of different cutoff values of rFLC and dFLC on clinical prognosis were evaluated.

RESULTS

The median progression-free survival time of female patients with M-protein IgA type and I stage for ISS stage were significantly longer than those of male, other M-protein types and other ISS stage（P<0.05）. The median OS of patients without hypercalcemia was significantly higher than that of patients with hypercalcemia（P<0.05）. The median progression-free survival(PFS) time of patients with dFLC <110.95 mg/L was significantly longer than that of patients with dFLC=110.95-2 781.44 mg/L and >2 781.44 mg/L（P<0.05）. The median overall survival time of patients with dFLC ＜110.95 mg/L and ＞2 781.44 mg/L was significantly longer than that of patients with dFLC=110.95-2 781.44 mg/L（P<0.05）. The median overall survival time of patients with rFLC <14.71 mg/L was significantly longer than that of patients with rFLC >14.71-367.96 mg/L and >367.96 mg/L（P<0.05）. Univariate analysis of Cox regression model indicated that dFLC at all levels showed higher influence on the OS and PFS of patients as compared with rFLC（P<0.05）. Multivariate analysis of Cox regression model showed that rFLC and dFLC expression level were the independent prognostic factors of patients（P<0.05）. The most significant influence value on clinical prognosis of patients were observed when rFLC level ≤14.71 or dFLC level ≤110.95 mg/L（P<0.05）. The median OS of patients with rFLC level ≤14.71 was significantly higher than that of other groups（P<0.05）. There was significant difference in median PFS between patients with rFLC ≤14.71 and ≥367.96 mg/L（P<0.05）. The median OS and PFS of patients with dFLC ≤110.95 mg/L were significantly longer than those in other two groups（P<0.05）.

CONCLUSION

The levels of rFLC and dFLC closely relate to clinical prognosis of patients with new diagnosed MM; the risk of recurrence or death is lowest in patients with rFLC level ≤14.71 mg/L or dFLC level ≤110.95 mg/L, which can be used as the ideal cutoff value for prognosis evaluation.