Impact of severe immunoparesis degree and duration on progression-free survival in newly diagnosed multiple myeloma: a retrospective cohort study of 258 patients.

OBJECTIVE

To investigate the relationship between the degree and duration of immunoparesis at diagnosis and poor prognosis in patients with newly diagnosed multiple myeloma (NDMM).

METHODS

A retrospective analysis was conducted on the clinical data of 258 patients with NDMM, including the status and duration of immunoparesis and the influence of other factors on prognosis.

RESULTS

91.5% of NDMM had varying degrees of immunoparesis. The median progression-free survival (PFS) was significantly shorter in the severe immunoparesis group than in the non-severe immunoparesis group (25 months vs. 34 months, P = 0.0149). The median PFS was significantly shorter in the groups with severe immunoparesis lasting ≥ 3, ≥ 6, and ≥ 12 months than in the group with non-severe immunoparesis lasting (P ≤0.05). Osteolytic lesions, 17p deletion/mutation, hemoglobin < 85g/L, and severe immunoparesis lasting ≥ 12 months were independent poor prognostic factors for PFS (all P < 0.05). Circulating plasma cells ≥ 2% and osteolytic lesions were independent poor prognostic factors for overall survival (OS) (all P < 0.05).

CONCLUSION

Immunoparesis at diagnosis and its duration are poor prognostic factors for PFS in patients with NDMM.