[Clinical study of multiple myeloma: a report of 182 cases]

To explore the applicability of Durie Salmon (DS) and International Staging System (ISS) for Chinese patients with multiple myeloma (MM) and to evaluate the efficacy of major therapeutic options and the influence of various prognostic factors on survival were also evaluated.

The patient survival was compared with regards to DS and ISS. Fourteen clinical and laboratory parameters were analyzed by univariate and multivariate process. Response rate, overall survival (OS) and progression-free survival (PFS) of 182 patients treated with different regimens were retrospectively analyzed.

The median survival of patients with DS stages I, II and III were 79, 82 and 43 months, respectively. There was no significance between stage I and II/III. The median survival of patients with ISS stages I, II and III were 79, 49 and 43 months, respectively. Multivariate analysis suggested that age, percentage of plasma cell in bone marrow, C-reactive protein (CRP) and beta2-microglobulin (2-MG) were independent prognostic factors for OS. The overall response rate (ORR) of 182 patients was 69.2% and median OS and PFS were 49.0+/-5.0 and 19.0+/-2.1 months, respectively. The 5- and 10-year OS were 34% and 19%, respectively. Compared with those not receiving thalidomide induction, the patients on a VAD-like regimen combined with thalidomide showed a superior ORR (81.5% vs 59.7%, P=0.008), a longer OS (79.0+/-29.5 vs 37.0+/-4.8 months, P=0.001) and a longer PFS (24.0+/-6.0 vs 14.0+/-2.7 months, P=0.033).

ISS is more applicable than DS, especially for low risk patients. The efficacy of VAD-like regimen combined Thal as first-line treatment is proven to be reliable. Induction therapy including thalidomide can not only improve the ORR, but also delay the relapse or progression of disease. It may even prolong the patient survival.