Clinical analysis of newly diagnosed multiple myeloma patients with renal dysfunction

Objective To explore the clinical features and prognostic factors of newly diagnosed multiple myeloma patients with renal insufficiency (MM-RI). Methods The clinical features, survival rates and prognostic factors were retrospectively analyzed for 897 newly diagnosed multiple myeloma (MM) patients at three hospital from January 1, 2010 to June 30, 2012. Results Among them, there were 177 cases (19.7%) of MM-RI patients. There were 125 males and 52 females with an average age of 59 years. And 28.2% (50/177) were over 65 years. The types were 17.2% (30/174) of immunoglobulin (Ig) D-λ and 27.6% (48/174) of light chain isotype. And the stages were 94.9% of DS stage Ⅲ(167/176) and ISS stage Ⅲ (166/175). Compared with MM patients with normal renal function (MM-RN), MM-RI group had a higher proportion of patients with IgD-λ and light chain isotype, more patients of DS and ISS stage Ⅲ; elevated bone marrow plasma cells, white blood cells and uric acid; lower hemoglobin and platelet (all P<0.05). After a median follow-up period of 24(2–114) months, the median progression-free survival (PFS) was 28.0 months for MM-RI patients and 29.0 months for MM-RN patients. And the difference was not statistically significant (P=0.457). The estimated median overall survival (OS) was 44.0 months for MM-RI patients and 59.2 months for MM-RN patients. And the difference was statistically significant (P=0.033). Log-rank univariate analysis showed that age, LDH, β2-MG, first-line treatment with or without bortezomib and previous transplantation or not were independent prognostic factors of MM patients. Conclusions MM-RI and MM-RN patients have different clinical features. Age, LDH, β2-MG, first-line treatment with or without bortezomib and previous transplantation or not are independent prognostic factors for newly diagnosed MM patients. Key words: Multiple myeloma; Renal insufficiency; Clinical feature; Prognosis