Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Department of biostatistics, Mayo Clinic, Rochester, MN, USA.
Blood Cancer J. 2023 May 15;13(1):78. doi: 10.1038/s41408-023-00852-4.
Overall survival estimates from diagnosis are valuable for guiding treatment, but do not consider the years already survived. Conditional survival (CS) provides dynamic survival predictions over time. This study was conducted to estimate CS at 1-8 years from diagnosis and the impact of baseline prognostic factors on CS in multiple myeloma (MM) patients. This is a retrospective study including 2556 MM patients diagnosed between 2004 and 2019. CS (t | s) was defined as the probability of surviving t years given survival of s years. Median age was 64 years. Median follow-up was 6.2 years and median overall survival from diagnosis was 7.5 years. The 5-year CS estimates at s = 0, 1, 2, 3, and 5 years were 0.64, 0.61, 0.61, 0.61, and 0.58, respectively. On multivariate analysis, age ≥ 65 and proteasome inhibitor+immunomodulatory-based induction were associated with decreased survival and increased survival, respectively, retained at 5 years. The adverse impact of 1q gain/amplification, high-risk IgH translocation, and ISS-3 was significant at 1 and 3 years but not 5 years. Chromosome 17 abnormality was associated with decreased survival only at 1 year. Among MM patients, 5-year CS was stable at 1-5 years from diagnosis. The prognostic impact of high-risk cytogenetic factors decreased with additional years survived.
从诊断起的总生存估计值对指导治疗很有价值，但并未考虑已经存活的年数。条件生存（CS）可随时间提供动态生存预测。本研究旨在评估多发性骨髓瘤（MM）患者从诊断起 1-8 年内的 CS，并分析基线预后因素对 CS 的影响。这是一项回顾性研究，纳入了 2004 年至 2019 年间诊断的 2556 例 MM 患者。CS（t|s）定义为给定 s 年生存时 t 年的生存概率。中位年龄为 64 岁。中位随访时间为 6.2 年，从诊断起的中位总生存时间为 7.5 年。s=0、1、2、3 和 5 年时的 5 年 CS 估计值分别为 0.64、0.61、0.61、0.61 和 0.58。多变量分析显示，年龄≥65 岁和蛋白酶体抑制剂+免疫调节剂诱导与生存降低和生存延长相关，在 5 年时仍然如此。1q 增益/扩增、高危 IgH 易位和 ISS-3 的不良影响在 1 年和 3 年显著，但在 5 年时不显著。染色体 17 异常仅在 1 年时与生存降低相关。在 MM 患者中，从诊断起 1-5 年内的 5 年 CS 较为稳定。高危细胞遗传学因素的预后影响随生存时间的延长而降低。
