Impact of type 2 and steroid-Induced diabetes mellitus on prognosis in patients with multiple myeloma.

OBJECTIVE

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).

METHODS

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.

RESULTS

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.

CONCLUSION

Both T2DM and SIDM were independently associated with poorer prognosis in patients with MM.