A Nomogram for Predicting Progression-Free Survival in Primary Extramedullary Multiple Myeloma Using Routine...

Area of Science:

• Hematology
• Oncology
• Medical Statistics

Background:

• Extramedullary involvement in multiple myeloma (MM) signifies aggressive disease.
• Clinical stratification of primary extramedullary disease (EMD) poses a significant challenge.

Purpose of the Study:

• To develop a validated nomogram for predicting individual survival in primary EMD patients.
• To utilize routine laboratory variables for risk stratification.

Main Methods:

• Retrospective analysis of 60 primary EMD patients (2006-2022).
• Identification of independent risk factors using Cox proportional hazard regression.
• Development and validation of a predictive nomogram.
• Classification into low- and high-risk groups based on nomogram scores.
• Survival analysis using Kaplan-Meier method.

Main Results:

• Median follow-up of 25.4 months; median progression-free survival (PFS) was 29.4 months.
• Identified Ki67, endothelial activation stress index (EASIX), and monocyte count as independent prognostic factors.
• The nomogram demonstrated significant predictive power, with low-risk patients having a median PFS of 37.1 months versus 2.6 months for high-risk patients (p<0.001).

Conclusions:

• A predictive nomogram for primary EMD patients has been successfully developed and validated.
• The nomogram effectively evaluates patient outcomes and stratifies risk.
• This tool aids in personalized treatment strategies for aggressive multiple myeloma with extramedullary disease.