Shao Jiaqi, Zhang Enfan, Chen Haoguang, Cai Zhen, Dong Mengmeng
Zhejiang University, School of Medicine, Hangzhou, China.
Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Acta Haematol. 2025;148(1):36-47. doi: 10.1159/000538479. Epub 2024 Mar 25.
Multiple myeloma (MM) is a malignant proliferative disease of plasma cells. Abnormally cloned plasma cells secrete large amounts of monoclonal immunoglobulins in the bone marrow of MM patients. Serum urea nitrogen (sUN) is a byproduct of protein metabolism, and its effect on MM patients' prognoses remains unknown. Therefore, we analyzed MM patients' clinical data to explore the role of sUN and sUN/serum albumin (sUAR) in the baseline tumor load and MM prognosis of MM patients.
We downloaded the clinical data of 762 MM patients from the MMRF database. After excluding those without baseline sUN, 452 patients were finally included in the study. Smoothed curve fitting, threshold analysis, Tamhane's T2 test, multivariate-adjusted Cox regression analysis, Kaplan-Meier (K-M) curves, and receiver operating characteristic (ROC) analysis were applied in the study.
There were 452 newly diagnosed MM patients included in this study. In most patient groups, sUN and sUAR were positively linked with β2-microglobulin (β2-MG) and lactic dehydrogenase (LDH) according to smoothing curve fitting and threshold analysis. The higher the ISS stage, the greater the values of sUN and sUAR. Furthermore, smoothed curve fitting and threshold analysis showed that sUN was correlated with overall survival (OS), although sUAR had a stronger correlation with OS and could be applied to a broader group. The results of a multivariate-adjusted Cox regression analysis demonstrated that sUN and sUAR were independent prognostic factors for OS. The K-M curve confirmed the correlation between higher sUN and sUAR levels and worse OS. β2-MG and LDH are generally recognized prognostic factors of OS. ROC analysis revealed that sUN might boost β2-MG and LDH's predictive value and sUAR had a higher predictive value.
This retrospective study based on the MMRF database showed that high sUN and sUAR levels were positively associated with β2-MG, LDH, and ISS staging, and sUAR exhibited a stronger correlation with OS than sUN alone.
Multiple myeloma (MM) is a malignant proliferative disease of plasma cells. Abnormally cloned plasma cells secrete large amounts of monoclonal immunoglobulins in the bone marrow of MM patients. Serum urea nitrogen (sUN) is a byproduct of protein metabolism, and its effect on MM patients' prognoses remains unknown. Therefore, we analyzed MM patients' clinical data to explore the role of sUN and sUN/serum albumin (sUAR) in the baseline tumor load and MM prognosis of MM patients.
We downloaded the clinical data of 762 MM patients from the MMRF database. After excluding those without baseline sUN, 452 patients were finally included in the study. Smoothed curve fitting, threshold analysis, Tamhane's T2 test, multivariate-adjusted Cox regression analysis, Kaplan-Meier (K-M) curves, and receiver operating characteristic (ROC) analysis were applied in the study.
There were 452 newly diagnosed MM patients included in this study. In most patient groups, sUN and sUAR were positively linked with β2-microglobulin (β2-MG) and lactic dehydrogenase (LDH) according to smoothing curve fitting and threshold analysis. The higher the ISS stage, the greater the values of sUN and sUAR. Furthermore, smoothed curve fitting and threshold analysis showed that sUN was correlated with overall survival (OS), although sUAR had a stronger correlation with OS and could be applied to a broader group. The results of a multivariate-adjusted Cox regression analysis demonstrated that sUN and sUAR were independent prognostic factors for OS. The K-M curve confirmed the correlation between higher sUN and sUAR levels and worse OS. β2-MG and LDH are generally recognized prognostic factors of OS. ROC analysis revealed that sUN might boost β2-MG and LDH's predictive value and sUAR had a higher predictive value.
This retrospective study based on the MMRF database showed that high sUN and sUAR levels were positively associated with β2-MG, LDH, and ISS staging, and sUAR exhibited a stronger correlation with OS than sUN alone.
多发性骨髓瘤（MM）是一种浆细胞恶性增殖性疾病。异常克隆的浆细胞在MM患者的骨髓中分泌大量单克隆免疫球蛋白。血清尿素氮（sUN）是蛋白质代谢的副产物，其对MM患者预后的影响尚不清楚。因此，我们分析了MM患者的临床数据，以探讨sUN和sUN/血清白蛋白（sUAR）在MM患者基线肿瘤负荷和MM预后中的作用。
我们从MMRF数据库下载了762例MM患者的临床数据。排除无基线sUN数据的患者后，最终纳入452例患者进行研究。本研究采用了平滑曲线拟合、阈值分析、塔姆黑尼T2检验、多变量调整Cox回归分析、Kaplan-Meier（K-M）曲线分析和受试者工作特征（ROC）分析。
本研究共纳入452例新诊断的MM患者。根据平滑曲线拟合和阈值分析，在大多数患者组中，sUN和sUAR与β2微球蛋白（β2-MG）和乳酸脱氢酶（LDH）呈正相关。国际分期系统（ISS）分期越高，sUN和sUAR值越大。此外，平滑曲线拟合和阈值分析表明，sUN与总生存期（OS）相关，尽管sUAR与OS的相关性更强，且可应用于更广泛的患者群体。多变量调整Cox回归分析结果表明，sUN和sUAR是OS的独立预后因素。K-M曲线证实了较高的sUN和sUAR水平与较差的OS之间的相关性。β2-MG和LDH是公认的OS预后因素。ROC分析显示，sUN可能提高β2-MG和LDH的预测价值，且sUAR具有更高的预测价值。
这项基于MMRF数据库的回顾性研究表明，高sUN和sUAR水平与β2-MG、LDH和ISS分期呈正相关，且sUAR与OS的相关性比单独的sUN更强。
多发性骨髓瘤（MM）是一种浆细胞恶性增殖性疾病。异常克隆的浆细胞在MM患者的骨髓中分泌大量单克隆免疫球蛋白。血清尿素氮（sUN）是蛋白质代谢的副产物，其对MM患者预后的影响尚不清楚。因此，我们分析了MM患者的临床数据，以探讨sUN和sUN/血清白蛋白（sUAR）在MM患者基线肿瘤负荷和MM预后中的作用。
我们从MMRF数据库下载了762例MM患者的临床数据。排除无基线sUN数据的患者后，最终纳入452例患者进行研究。本研究采用了平滑曲线拟合、阈值分析、塔姆黑尼T2检验、多变量调整Cox回归分析、Kaplan-Meier（K-M）曲线分析和受试者工作特征（ROC）分析。
本研究共纳入452例新诊断的MM患者。根据平滑曲线拟合和阈值分析，在大多数患者组中，sUN和sUAR与β2微球蛋白（β2-MG）和乳酸脱氢酶（LDH）呈正相关。国际分期系统（ISS）分期越高，sUN和sUAR值越大。此外，平滑曲线拟合和阈值分析表明，sUN与总生存期（OS）相关，尽管sUAR与OS的相关性更强，且可应用于更广泛的患者群体。多变量调整Cox回归分析结果表明，sUN和sUAR是OS的独立预后因素。K-M曲线证实了较高的sUN和sUAR水平与较差的OS之间的相关性。β2-MG和LDH是公认的OS预后因素。ROC分析显示，sUN可能提高β2-MG和LDH的预测价值，且sUAR具有更高的预测价值。
这项基于MMRF数据库的回顾性研究表明，高sUN和sUAR水平与β2-MG、LDH和ISS分期呈正相关，且sUAR与OS的相关性比单独的sUN更强。
