title: Prognostic factors and staging systems of multiple myeloma:.
abstract: BACKGROUND
  Previous studies found a range of prognostic factors but no consensus about the proper staging system for multiple myeloma has been achieved. This study explored the prognostic factors to find a staging system for multiple myeloma most suitable for Chinese patients.
  
  
  METHODS
  Between February 1990 to August 2004, 206 patients (138 men and 68 women, mean aged (59 +/- 11) years) who were initially diagnosed as multiple myeloma in Changzheng Hospital (Shanghai, China) and had followup records were enrolled in this study. Potential prognostic factors were evaluated by univariate and multivariate analyses. Four staging systems were applied to compare their suitability for the patients.
  
  
  RESULTS
  The median survival time of the patients was 33 months. The 1-, 3- and 5-year survival rates were 80.18%, 48.08% and 33.7% respectively. Factors identified as adversely affecting survival were older age, severe bone lesions, low haemoglobin, low platelet, low serum calcium, low serum albumin, high proportion of plasma cells in marrow, high serum creatinine, high serum beta(2) microglobulin and high C-reactive protein. Among these, only C-reactive protein, beta(2) microglobulin, albumin and age were the independent prognostic factors. There were statistically significant survival differences among the three groups in Durie Salmon staging system and Bataille staging system, but not in British Medical Research Council staging system or International Staging System.
  
  
  CONCLUSIONS
  High beta(2) microglobulin, high C-reactive protein, low albumin and old age are independent prognostic factors of multiple myeloma. Bataille staging system appears to be optimal for Chinese multiple myeloma patients.
authors.affiliation: Department of Haematology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
authors.forename: Zhong-fei
authors.initials: ZF
authors.lastname: Tao
authors.forename: Wei-jun
authors.initials: WJ
authors.lastname: Fu
authors.forename: Zhen-gang
authors.initials: ZG
authors.lastname: Yuan
authors.forename: Dong-xing
authors.initials: DX
authors.lastname: Wang
authors.forename: Yu-bao
authors.initials: YB
authors.lastname: Chen
authors.forename: Jian
authors.initials: J
authors.lastname: Hou
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000401:mortality* / Q000473:pathology; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate
chemical_list: D015850:Interleukin-6; D002097:C-Reactive Protein