血细胞积分对以硼替佐米为基础一线治疗的多发性骨髓瘤患者的预后评估作用

OBJECTIVE: This study aims to evaluate the prognostic effect of peripheral blood cells in multiple myeloma（MM）patients treated with bortezomib. METHODS: The clinical data of 155 newly diagnosed MM patients in two blood disease treatment centers from January 2014 to December 2016 were retrospectively studied. All patients received bortezomib as the first-line treatment. The results of the peripheral blood cell counts, including absolute neutrophil count, absolute monocyte count（AMC）, hemoglobin level, mean corpuscular volume（MCV）, and platelet count, and other clinical features were analyzed. RESULTS: AMC（>0.6×10(9)/L）, MCV（>99.1 fl）, and platelet count（<150×10(9)/L）significantly affected patients' PFS and OS. The above three factors were assigned 1 point, respectively, to form the blood cell score. The analysis showed that 64 cases（41.3％）had a score of 0, 57 cases（36.8％）had 1, 32 cases（20.6％）had 2, and 2 cases（1.3％）had 3. The median PFS of the four groups were 42.8 m, 26.5 m, 15.8 m, and 6.4 m, respectively（P<0.001）. The median OS were NR, 48.2 m, 31.1 m, and 31.4 m, respectively（P＝0.001）. Multivariate analysis suggested that the blood cell score（2–3 vs 0–1）and the proportion of marrow plasma cells（>30％）were independent prognostic factors for PFS（HR＝1.95 and 1.76, respectively）, while age（>65y vs≤65y）, R-ISS stage（3 vs 1–2）, and blood cell score（2–3 vs 0– 1）were independent prognostic factors for OS（HR＝2.08, 2.13 and 2.12, respectively）. CONCLUSION: As an easy-to-access biomarker, the blood cell score can be used to evaluate the prognosis of newly diagnosed MM patients in the era of new drugs, but it is still necessary to expand the cases and make further confirmation in the prospective study.