[Prognostic analysis and assessment on the clinical staging systems of multiple myeloma--a report of 206 cases].
OBJECTIVE
Multiple myeloma (MM) is a heterogeneous disease of plasma cell tumor with poor prognosis. This study was to explore the prognostic factors of MM in China, and find the most suitable clinical staging systems.


METHODS
Univariate and multivariate analyses were carried out on 18 clinical and laboratory indexes from 206 MM patients. These MM patients were classified according to 4 staging systems to compare their survival status.


RESULTS
Of the 206 patients, 138 were men and 68 were women, with median age of 59 years (ranged 27-90 years) and median survival time of 33 months. The 2-and 5-year survival rates were 64.7% and 33.7%. Univariate analysis identified 10 prognostic factors: age, the amount of bone marrow plasma cells, hemoglobin, platelet count, adjusted serum calcium, albumin, creatinine, beta2 microglobulin, C-reactive protein, and skeletal disease stage. Multivariate analysis showed that C-reactive protein, beta2 microglobulin, albumin, age were independent prognostic factors. Significant differences of survival period existed among the 3 groups classified according to Durie Salmon staging system and Bataille staging system as well as between group I and group II of International staging system. However, no significant difference was found among the 3 groups classified according to British Medical Research Council staging system and between group II and group III of International staging system.


CONCLUSIONS
High level of C-reactive protein, high level of beta2 microglobulin, low level of albumin and old age are correlated to poor prognosis. Durie Salmon staging system and Bataille staging system are suitable for Chinese MM patients.
Tao
Zhong-Fei
ZF
Department of Hematology, Changzheng Hospital, The Second Military Medical University, Shanghai 200003, P. R. China.
Fu
Wei-Jun
WJ
Chen
Yu-Bao
YB
Yuan
Zhen-Gang
ZG
Wang
Dong-Xing
DX
Hou
Jian
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000473:pathology; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012709:Serum Albumin / Q000378:metabolism; D015996:Survival Rate; D001613:beta 2-Microglobulin / Q000097:blood*
D012709:Serum Albumin; D001613:beta 2-Microglobulin; D002097:C-Reactive Protein