Prognostic evaluation in multiple myeloma:: an analysis of the impact of new prognostic factors

被引:0
|
作者
Turesson, I [1 ]
Abildgaard, N
Ahlgren, T
Dahl, IM
Holmberg, E
Hjorth, M
Nielsen, JL
Odén, A
Seidel, C
Waage, A
Westin, J
Wislöff, F
机构
[1] Malmo Univ Hosp, Dept Med, S-20502 Malmo, Sweden
[2] Aarhus Univ Hosp, Dept Med & Haematol, DK-8000 Aarhus, Denmark
[3] Univ Tromso Hosp, Dept Med, N-9038 Tromso, Norway
[4] Sahlgrens Univ Hosp, Ctr Oncol, S-41345 Gothenburg, Sweden
[5] Lidkoping Hosp, Dept Med, Lidkoping, Sweden
[6] Norwegian Univ Sci & Technol, Inst Canc Res & Mol Biol, N-7034 Trondheim, Norway
[7] Univ Trondheim Hosp, Dept Med, N-7006 Trondheim, Norway
[8] Univ Lund Hosp, Dept Med, S-22185 Lund, Sweden
[9] Ullevaal Univ Hosp, Dept Med, Oslo, Norway
关键词
multiple myeloma; survival; prognostic factors; risk score;
D O I
暂无
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
We have analysed the prognostic information for survival of presenting features in an unselected series of 394 myeloma patients. 15 variables with significant prognostic information were identified, among these were some not previously or only recently reported: serum levels of hepatocyte growth factor (HGF), interleukin-6 (IL-6), C-terminal crosslinked telopeptide of collagen I (ICTP) and soluble interleulrin-6 receptor (siL-6R). In a multivariate Cox analysis six variables were significantly and independently associated with poor survival: high age, low W.H.O.-performance status (PS), high serum levels of calcium, beta-2-microglobulin (beta-2M), IL-6 and sIL-6R, A risk score formed to predict survival for each percentile of the patient population allowed an efficient separation of prognostic groups. The discriminating power of the model compared favourably with three other previously published staging systems applied to the study population, Exclusion of IL-6 and sIL-6R from the model only marginally decreased the efficacy of the separation. The predictive value of some variables (sIL-6R, beta-2M and W.H.O.-PS) decreased significantly over time. We conclude that formation of a risk score based on independent variables is an efficient way to separate prognostic groups, that the contribution of new and not easily available parameters should be thoroughly evaluated before inclusion in prognostic models for clinical use and that the predictive value of parameters may decrease over time.
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收藏
页码:1005 / 1012
页数:8
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