Wang Ji-Heng, Xiang Pu, Zhao Er-Jiang, Liu Li-Na, Liu Yu-Zhang, Liang Li-Jie, Cui Yu-Shan, Fang Bai-Jun
Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan Province, 450008, China.
Department of Hematology, Henan Hematology Institute, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, No. 127 of Dongming Road, Jinshui District, Zhengzhou, Henan Province, 450008, China.
World J Surg Oncol. 2025 Aug 30;23(1):330. doi: 10.1186/s12957-025-03982-0.
This study aimed to investigate the association between type 2 diabetes mellitus (T2DM) and steroid-induced diabetes mellitus (SIDM) with prognosis in patients with multiple myeloma (MM).
A retrospective analysis was conducted on patients initially diagnosed with MM at Henan Provincial Cancer Hospital between January 2005 and December 2016. Patients were categorized into three groups: MM without diabetes mellitus, MM with T2DM, and MM with SIDM.
A cohort of 1,463 patients were included in this study, comprising 818 patients with MM without diabetes mellitus, 217 with MM and T2DM, and 428 with MM and SIDM. Independent predictors of overall survival (OS) in the entire cohort included age (hazard ratio [HR] = 1.011, 95% confidence interval [CI]: 1.007-1.016, p < 0.001), International Staging System (ISS) stage III (HR = 1.463, 95% CI: 1.273-1.681, p < 0.001), hematopoietic stem cell transplantation (HSCT) (HR = 0.334, 95% CI: 0.286-0.390, p < 0.001), chromosomal abnormalities (HR = 11.999, 95% CI: 9.688-14.860, p < 0.001), T2DM (HR = 1.606, 95% CI: 1.409-1.829, p < 0.001), and SIDM (HR = 1.224, 95% CI: 1.038-1.444, p = 0.016). Among patients with MM and SIDM, age (HR = 1.047, 95% CI: 1.037-1.057, p < 0.001), ISS stage III (HR = 1.796, 95% CI: 1.389-2.322, p < 0.001), lactate dehydrogenase (HR = 1.004, 95% CI: 1.002-1.006, p < 0.001), HSCT (HR = 0.284, 95% CI: 0.213-0.382, p < 0.001), and chromosomal abnormalities (HR = 14.59, 95% CI: 9.822-21.674, p < 0.001) were independently associated with OS. In patients with MM and T2DM, ISS stage II (HR = 2.008, 95% CI: 1.418-2.844, p < 0.001), ISS stage III (HR = 3.126, 95% CI: 2.110-4.631, p < 0.001), HSCT (HR = 0.264, 95% CI: 0.173-0.403, p < 0.001), and chromosomal abnormalities (HR = 32.677, 95% CI: 17.632-60.560, p < 0.001) were independently associated with OS.
Both T2DM and SIDM were independently associated with poorer prognosis in patients with MM.
本研究旨在探讨2型糖尿病（T2DM）和类固醇诱导的糖尿病（SIDM）与多发性骨髓瘤（MM）患者预后之间的关联。
对2005年1月至2016年12月在河南省肿瘤医院初诊为MM的患者进行回顾性分析。患者分为三组：无糖尿病的MM、伴T2DM的MM和伴SIDM的MM。
本研究共纳入1463例患者，包括818例无糖尿病的MM患者、217例伴T2DM的MM患者和428例伴SIDM的MM患者。整个队列中总生存期（OS）的独立预测因素包括年龄（风险比[HR]=1.011，95%置信区间[CI]：1.007 - 1.016，p<0.001）、国际分期系统（ISS）III期（HR = 1.463，95% CI：1.273 - 1.681，p<0.001）、造血干细胞移植（HSCT）（HR = 0.334，95% CI：0.286 - 0.390，p<0.001）、染色体异常（HR = 11.999，95% CI：9.688 - 14.860，p<0.001）、T2DM（HR = 1.606，95% CI：1.409 - 1.829，p<0.001）和SIDM（HR = 1.224，95% CI：1.038 - 1.444，p = 0.016）。在伴SIDM的MM患者中，年龄（HR = 1.047，95% CI：1.037 - 1.057，p<0.001）、ISS III期（HR = 1.796，95% CI：1.389 - 2.322，p<0.001）、乳酸脱氢酶（HR = 1.004，95% CI：1.002 - 1.006，p<0.001）、HSCT（HR = 0.284，95% CI：0.213 - 0.382，p<0.001）和染色体异常（HR = 14.59，95% CI：9.822 - 21.674，p<0.001）与OS独立相关。在伴T2DM的MM患者中，ISS II期（HR = 2.008，95% CI：1.418 - 2.844，p<0.001）、ISS III期（HR = 3.126，95% CI：2.110 - 4.631，p<0.001）、HSCT（HR = 0.264，95% CI：0.173 - 0.403，p<0.001）和染色体异常（HR = 32.677，95% CI：17.632 - 60.560，p<0.001）与OS独立相关。
T2DM和SIDM均与MM患者较差的预后独立相关。
