Correlation of blood transfusion to progression-free survival and overall survival in multiple myeloma patients undergoing chemotherapy.

The prognostic impact of blood transfusion in multiple myeloma (MM) remains uncertain, with limited data, particularly from the Indian subcontinent. This study evaluated the association of transfusion requirements with Revised International Staging System (RISS) stage, progression-free survival (PFS), and overall survival (OS) in MM patients undergoing chemotherapy. We conducted a retrospective observational study of newly diagnosed MM patients receiving chemotherapy between January 2012 and March 2023 at a tertiary care center, excluding those undergoing stem cell transplantation. Patients were stratified into two cohorts: < 5 units versus ≥ 5 units of packed red cells and/or platelets received during induction, consolidation, and maintenance. Clinical, laboratory, and treatment characteristics were compared, and survival outcomes were analyzed using log-rank tests and Cox regression. Of 44 patients (mean age 63.7 ± 10.4 years, male: female ratio 1.4:1), 20 (45.5 %) received ≥ 5 transfusions. This cohort had significantly higher RISS stage (p = 0.038), more relapses (p = 0.008), and greater need for multiple chemotherapy regimens (p = 0.02). Patients receiving < 5 transfusions demonstrated significantly longer PFS (p = 0.013). Spearman correlation showed a positive association between transfusion number and RISS stage (r = 0.6, p < 0.05), while transfusion burden negatively correlated with both PFS and OS. Our findings suggest that higher transfusion may be a prognostic risk factor inversely affecting PFS and OS in multiple myeloma patients undergoing chemotherapy.