Correlation of IgG Levels at Initial Diagnosis with Clinical Efficacy and Prognosis in 66 Patients with IgG Multiple Myeloma / 中国实验血液学杂志

ABSTRACT

OBJECTIVE@#To explore the IgG levels of newly diagnosed IgG-type multiple myeloma (MM) patients and analyze the relationship between the IgG levels and clinical efficacy and prognosis.@*METHODS@#The clinical data of 66 newly diagnosed IgG-type MM patients in our hospital from September 2012 to October 2018 were collected. These 66 patients were divided into group A (IgG≤64 g/L, n=41), and group B (IgG ＞64 g/L, n=25), then the MM patients in 2 groups were divided into 2 subgroups thalidomide (TM)-treated group (n=35) and bortezomib (BTZ)-treated group (n=25) according to therapeutic regimens. The climical efficacy, PFS and OS time as well as the factors affecting prognosis of patients were compared and analyzed.@*RESULTS@#The overall response rate (ORR) and CR+VGPR rate in group A were better than those in group B (P=0.008, P=0.036), the ORR of BTZ-treated group in group B was significantly better than that of TM-treated group (P=0.028), while the ORR of TM-treated group in group A was better than that of TM-treated group in group B (P=0.048), the CR+VGPR rate was better than that of TM-treated group in group B (P＜0.05). The number of patients with high risk cytogenetics (HRC) in group B was much more than that in group A (P=0.022). Spearman correlation analysis showed that serum IgG levels negatively correlated with albumin (r=-0.449，P=0.000) and hemoglobin (r=-0.608，P=0.000), and positively correlated with bone marrow plasma cells (r=0.328，P=0.007). Survival analysis showed that the PFS in group A was significantly better than that in group B (P=0.015), and the OS in group A was better than that in group B (P=0.049), but there was no significant difference in PFS and OS between TM group and BTZ group (PFS P=0.695, OS P=0.3250). Cox multivariate regression analysis showed that the ≥VGPR and standard-risk cytogenetics were independent prognostic factors for PFS and OS.@*CONCLUSION@#IgG＞64g/L in patients with newly diagnosed IgG-type MM is a poor prognostic factor affecting PFS and OS. The higher level of serum IgG at the initial diagnosis, the higher the risk of HRCs, and the worse clinical efficacy and prognosis of patients.