单中心40岁以下初治多发性骨髓瘤患者临床表现及生存分析并文献复习

OBJECTIVE: To investigate the clinical characteristics and prognosis of very young patients with multiple myeloma (MM). METHODS: We retrospectively analyzed the clinical characteristics and outcome of 35 newly diagnosed MM patients 40 years old or younger during a period of 15 years and compared with published data from western countries. RESULTS: Our study demonstrated that these very young patients were more likely to be in advanced stage of International staging system, IgD isotype, hemoglobin<100 g/L, decreased platelets and deletion of 17p13. With a median follow-up of 17months (1–89 months), the median overall survival (OS) of this cohort was 33 months and progression-free survival (PFS) was 13 months, moreover 8 of 17 deaths occurred in the first year after diagnosis. In the univariate analysis, extramedullary infiltration, del (17p13) and renal impairment were associated with reduced PFS (P=0.031, P=0.015, P=000, respectively), while the last two factors also predicted inferior OS (P=0.015, P=0.001), but multivariate analysis showed that only renal impairment independently associated with inferior survival in COX model (PFS: HR=3.953, 95% CI 1.263–12.371, P=0.018; OS: HR=5.769, 95% CI 1.602–20.771, P=0.007). CONCLUSION: Our research showed for the first time that the clinical characteristics and survival of MM patients ≤40 years old in China were different from that in western countries. The special attention should be paid to the patients with their diagnosis and treatment.