Comprehensive evaluation of clinical prognostic parameters in a real-world cohort of 812 patients with multiple myeloma

Abstract Objectives Multiple myeloma (MM) is an incurable malignancy with heterogeneous clinical manifestations and prognoses. The existing staging systems offer assistance in prognosis determination, yet their accuracy in the real-world context is limited, and numerous crucial parameters have been disregarded. Comprehensive exploration of prognostic value parameters for MM patients in the real world is of paramount significance. Methods In this study, 812 newly diagnosed MM patients treated with standard first-line therapy at Zhongshan Hospital Fudan University from January 2010 to April 2021 were enrolled, representing one of the largest MM cohorts in China. Among them, 703 patients did not receive transplantation (527 in the training set and 176 in the validation set), and 109 patients underwent transplantation. Forty-three baseline parameters encompassing clinical, laboratory, and pathological features were incorporated. Univariate and multivariate Cox analyses were conducted to screen the most prognostically significant parameters. Results The results revealed that ten parameters, including ECOG score, extramedullary lesions, platelet count, reticulocyte count, anion gap, hypercalcemia, complement C3, β2-microglobulin, cytogenetics, and interleukin-2 receptor, were of the greatest prognostic value. These parameters include some integrated into current mainstream staging systems and many previously overlooked. A risk scoring system was developed using these ten parameters, demonstrating relatively high accuracy. Conclusion This research comprehensively evaluated the baseline disease characteristics of a wide range of MM patients, validated and identified the clinical significance of various parameters, providing new evidence for accurate prognosis determination of patients.