Korean J Med.  2000 Jan;58(1):83-90.

Prognostic factors affecting response to chemotherapy and survival duration in Korean patients with multiple myeloma

• Song HH
• Lee JH
• Park JB
• Choi SJ
• Kim JK
• Kim SB
• Kim SW
• Suh CW
• Lee KH
• Lee JS
• Kim WK
• Park CJ
• Chi HS
• Kim SH

Abstract

BACKGROUND: New therapeutic modalities such as high dose chemotherapy and stem cell support have been tried to prolong the survival period of the patients with multiple myeloma. However, little is known about the criteria for the application of those new therapies. There are only a few reports for the prognostic factors of multiple myeloma in Korea. The purpose of this study is to analyze the prognostic factors affecting chemotherapy response and survival in patients with multiple myeloma.
METHODS
We retrospectively analysed the clinical records of 122 patients who were newly diagnosed as multiple myeloma by SWOG criteria, between November, 1989 and April, 1997 at Asan Medical Center.
RESULTS
1) The peak incidence was the 7th decade and male to female ratio was 1.3:1. The most common presenting symptom at first diagnosis was bone pain. 2) Initial clinical stage was as followed: stage I in 17.2% , stage II in 16.4% and 66.4% in III. The immunoglobulin classes were IgG in 51.6%, light chain only in 25.4%, IgA in 16.4%, IgD in 4.1%, and non-secretory type in 2.5%. Plasma cell types in bone marrow were classified as plasmablastic type in 45.9%, plasmacytic type in 54.1%. 3) Eighty two patients who recieved chemotherapy more than 3 cycles were evaluable for chemotherapy response. Overall response rate was 69.5%. Factors affecting response to chemotherapy were serum creatinine level, plasma cell type, total plasma cell percentage and plasmablast percentasge of total nucleated cells in bone marrow. 4) For total 122 patients, overall median survival period was 21 months, and estimated 5 year survival rate was 23.5%. Factors affecting survival were serum creatinine, corrected calcium, albumin, beta2-microglobulin level, response to chemotherapy, total plasma cell percentage and plasmablast percentage in bone marrow.
CONCLUSION
Bone marrow findings at initial diagnosis are significantly associated with response to chemotherapy and survival duration.

Keyword

Multiple myeloma; Prognostic factors to chemotherapy response; Survival

MeSH Terms

Bone Marrow
Calcium
Chungcheongnam-do
Creatinine
Diagnosis
Drug Therapy*
Female
Humans
Immunoglobulin A
Immunoglobulin D
Immunoglobulin G
Immunoglobulin Isotypes
Incidence
Korea
Male
Multiple Myeloma*
Plasma Cells
Retrospective Studies
Stem Cells
Survival Rate
Calcium
Creatinine
Immunoglobulin A
Immunoglobulin D
Immunoglobulin G
Immunoglobulin Isotypes