Comparison of characteristics of patients followed with multiple myelom, with long-term survival and short-term survival

Introduction and Objective: Multiple Myeloma is a malignancy originating from plasma cells with a 5-year survival rate of 50.7%. However, patients with a total survival of more than 10 years are known. Factors affecting the survival time; It can be grouped as tumor character, patient character and response to treatment. In our study, we aimed to examine the factors affecting the survival difference between patients with a total survival of over 6 years and those with a total survival of less than 3 years. Methods and Materials: The study included 150 newly diagnosed multiple myeloma cases in Dokuz Eylul University Faculty of Medicine Adult Hematology Clinic between January 2005 and December 2015. Demographic data, charlson comorbidity index scores, serum albumin level at diagnosis, creatinine, calcium, lactate dehydrogenase (LDH), hemoglobin level, lymphocyte level, neutrophil level, monocyte level, erythrocyte distribution width (RDW), immunoglobulin subgroups, ISS (International Staging System) score, history of OKHN, history of bone involvement, treatment response before OKHN in patients who underwent OKCN, response after OKHN, sequential treatment dates, and progression-free survival end dates of the patients were evaluated retrospectively using patient files and electronic registry system. Results: 150 patients were divided into two groups as 65 patients with a total survival of less than 3 years and 85 patients with a total survival of more than 6 years. As a result of the comparison between the two groups, a significant correlation was found between ISS stage, CMI, Albumin, Creatinine, CRAB numbers and age at the time of diagnosis. There was no significant relationship between the two groups in terms of gender, RDW values and bone involvement history. A history of OKHN was found to be significant between the two groups. The proportion of patients with VGPR and CR before OKHN treatment response was significantly higher in patients with TS >6 years. The 100-day response after OKHN was significantly lower in those who lived less than 3 years. When the duration of PFS1 was examined, a significant difference was found between the two groups (p<0.001). Calculation was made until the 5th PFS time, from the 1st PFS time to the 5th PFS time, except for the difference between the 2nd PFS time and the 3rd PFS time, the decrease in other times was found to be significant. In addition, long (>12 months) 4th PFS and 3rd PFS times were detected in the advanced treatment lines. Discussion and Conclusion: In our study, we found that blood and imaging examinations, especially during the diagnosis process, gave an idea about overall survival. We demonstrated the effect of depth of response on overall survival of OKHN eligible patients before OKCN transplantation. Although shortening of PFS times is an expected finding, long PFS periods seen during advanced treatment may be associated with the introduction of new generation treatments. Our study reveals the effect of deeper responses before autologous transplantation, supports the importance of consolidation and maintenance treatments with the 100th day response after OKHN, and also supports studies showing the effectiveness of multiple combinations with new drugs. Keywords: Multiple myeloma, overall survival, prognosis, autologous stem cell transplantation, progression-free survival