Cheng Qianwen, Cai Li, Zhang Yuyang, Chen Lei, Hu Yu, Sun Chunyan
Institute of Hematology, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China.
Front Oncol. 2021 Mar 5;11:639528. doi: 10.3389/fonc.2021.639528. eCollection 2021.
To investigate the prognostic value of circulating plasma cells (CPC) and establish novel nomograms to predict individual progression-free survival (PFS) as well as overall survival (OS) of patients with newly diagnosed multiple myeloma (NDMM). One hundred ninetyone NDMM patients in Wuhan Union Hospital from 2017.10 to 2020.8 were included in the study. The entire cohort was randomly divided into a training ( = 130) and a validation cohort ( = 61). Univariate and multivariate analyses were performed on the training cohort to establish nomograms for the prediction of survival outcomes, and the nomograms were validated by calibration curves. When the cut-off value was 0.038%, CPC could well distinguish patients with higher tumor burden and lower response rates ( < 0.05), and could be used as an independent predictor of PFS and OS. Nomograms predicting PFS and OS were developed according to CPC, lactate dehydrogenase (LDH) and creatinine. The C-index and the area under receiver operating characteristic curves (AUC) of the nomograms showed excellent individually predictive effects in training cohort, validation cohort or entire cohort. Patients with total points of the nomograms ≤ 60.7 for PFS and 75.8 for OS could be defined as low-risk group and the remaining as high-risk group. The 2-year PFS and OS rates of patients in low-risk group was significantly higher than those in high-risk group ( < 0.001). CPC is an independent prognostic factor for NDMM patients. The proposed nomograms could provide individualized PFS and OS prediction and risk stratification.
为了研究循环浆细胞（CPC）的预后价值，并建立新的列线图以预测新诊断的多发性骨髓瘤（NDMM）患者的个体无进展生存期（PFS）和总生存期（OS）。纳入了2017年10月至2020年8月在武汉协和医院就诊的191例NDMM患者。将整个队列随机分为训练组（n = 130）和验证组（n = 61）。对训练组进行单因素和多因素分析以建立预测生存结局的列线图，并通过校准曲线对列线图进行验证。当临界值为0.038%时，CPC能够很好地区分肿瘤负荷较高和缓解率较低的患者（P < 0.05），并且可作为PFS和OS的独立预测因子。根据CPC、乳酸脱氢酶（LDH）和肌酐制定了预测PFS和OS的列线图。列线图的C指数和受试者工作特征曲线下面积（AUC）在训练组、验证组或整个队列中均显示出良好的个体预测效果。列线图总分PFS≤60.7分且OS≤75.8分的患者可定义为低风险组，其余为高风险组。低风险组患者的2年PFS率和OS率显著高于高风险组（P < 0.001）。CPC是NDMM患者的独立预后因素。所提出的列线图可为个体的PFS和OS预测及风险分层提供依据。
