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Early Identification of the Non-Transplanted Functional High-Risk Multiple Myeloma: Insights from a Predictive
Yanjuan Li1, Lifen Kuang1, Beihui Huang1
1Department of Haematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Biomedicines
|January 25, 2025
Summary
A new nomogram predicts functional high-risk (FHR) multiple myeloma (MM) in non-transplanted patients. Key factors include younger age, high LDH, specific M-protein decline patterns, and suboptimal induction response, aiding early risk stratification.
Area of Science:
- Hematology
- Oncology
- Biostatistics
Background:
- Multiple myeloma (MM) patients with suboptimal response or early relapse are functional high-risk (FHR) with poor prognosis.
- Non-transplanted FHR MM patients require accurate predictive tools for timely intervention.
Purpose of the Study:
- To develop and validate a predictive nomogram for non-transplanted functional high-risk multiple myeloma patients.
- To identify independent risk factors associated with FHR MM in this specific patient cohort.
Main Methods:
- Retrospective analysis of 215 non-transplanted MM patients.
- Univariate and multivariate logistic regression to identify risk factors.
- Nomogram construction and validation using AUC, calibration curves, DCA, and CIC.
Main Results:
- Younger age, LDH ≥ 220 U/L, M-protein decline pattern A+C, and induction efficacy < VGPR were independent risk factors.
- Nomogram achieved high predictive accuracy with AUCs of 0.940 (training) and 0.978 (validation).
- Clinical utility confirmed by DCA and CIC analyses.
Conclusions:
- A validated nomogram facilitates early prediction of non-transplant FHR MM.
- Identified risk factors (age, LDH, M-protein decline, induction response) aid in risk stratification.
- Lack of maintenance therapy is associated with increased risk of early progression or relapse.
