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Diagnostic Potential of the Risk Factors Associated With Peripheral Neuropathy in Multiple Myeloma: Evidence From
1Department of Hematology, Ganzhou People's Hospital, Ganzhou, Jiangxi, China.
Abstract:
Aims/Background Peripheral neuropathy (PN) is a common and debilitating complication in patients with multiple myeloma (MM), which results from both disease-related mechanisms and treatment-induced neurotoxicity. Despite its clinical significance, comprehensive investigations assessing PN risk in MM, along with examining demographic, clinical, nutritional, and inflammatory factors, remain limited. Therefore, this study aimed to investigate independent risk predictors associated with PN in MM patients using univariate and multivariate logistic regression analysis, thereby enhancing clinical risk management and improving treatment outcomes. Methods This retrospective observational study included 161 MM patients who were treated at Ganzhou People's Hospital between February 2020 and February 2024. Study participants were divided into the PN (n = 45) and non-PN (n = 116) groups. PN diagnosis was conducted based on new neurological signs and symptoms post-treatment, confirmed through abnormal sensory, motor, autonomic, or nerve conduction assessments. Baseline characteristics, including demographic information, clinical features, and laboratory parameters, were compared between the two groups using Mann-Whitney U and Chi-square tests. Univariate logistic regression analysis evaluated potential parameters associated with PN. Furthermore, a multivariate logistic model was used to assess independent risk predictors. Finally, model performance was evaluated via receiver operating characteristic (ROC) curve analysis. Results This study analyzed 161 patients, of whom 45 (27.95%) developed PN. Patients in the PN group were significantly older, and had higher body mass index (BMI), increased immunoglobulin G (IgG) and interleukin-6 (IL-6) levels, and increased diabetes prevalence than the non-PN group. However, they exhibited lower hemoglobin (Hb) and serum 25-hydroxyvitamin D [25(OH)D] levels (p < 0.05). Multivariate logistic regression analysis identified older age (odds ratio [OR] = 1.49, 95% confidence interval [CI]: 1.07-2.08), higher BMI (OR = 2.05, 95% CI: 1.01-4.17), reduced 25(OH)D levels (OR = 0.54, 95% CI: 0.29-0.97), elevated IgG (OR = 1.64, 95% CI: 1.12-2.41), and increased IL-6 (OR = 2.07, 95% CI: 1.10-3.88) as independent PN predictor. The model showed excellent discrimination capability (area under the curve [AUC] = 0.998, 95% CI: 0.996-1.000, p < 0.001). Conclusion This study identified older age, higher BMI, vitamin D deficiency, elevated IgG, and increased IL-6 levels as independent risk predictors for PN. Assessing these parameters in the early stages facilitates the identification of high-risk patients, allowing for targeted preventive strategies and personalized nursing interventions in MM patients which can reduce PN incidence and enhance overall clinical outcomes.
Insights
Peripheral neuropathy (PN) in multiple myeloma (MM) patients is predicted by older age, higher BMI, vitamin D deficiency, elevated IgG, and increased IL-6. Early assessment of these factors aids in managing PN risk and improving patient outcomes.
Area of Science:
- Hematology
- Neurology
- Oncology
Background:
- Peripheral neuropathy (PN) is a frequent complication in multiple myeloma (MM) patients, stemming from disease processes and treatment neurotoxicity.
- Limited research exists on comprehensive PN risk factors in MM, including demographic, clinical, nutritional, and inflammatory markers.
- Identifying independent predictors of PN is crucial for effective clinical risk management and improved treatment outcomes in MM.
Purpose of the Study:
- To investigate independent risk predictors for peripheral neuropathy (PN) in multiple myeloma (MM) patients.
- To utilize univariate and multivariate logistic regression analyses to identify key predictive factors.
- To enhance clinical risk management strategies and improve treatment outcomes for MM patients experiencing PN.
Main Methods:
- A retrospective observational study involving 161 MM patients treated between February 2020 and February 2024.
- Patients were categorized into PN (n=45) and non-PN (n=116) groups based on neurological assessments.
- Logistic regression and ROC curve analysis were employed to identify independent risk predictors and evaluate model performance.
Main Results:
- Older age, higher BMI, elevated immunoglobulin G (IgG), and increased interleukin-6 (IL-6) levels were associated with increased PN risk.
- Lower hemoglobin (Hb) and serum 25-hydroxyvitamin D [25(OH)D] levels were observed in the PN group.
- Multivariate analysis confirmed older age, higher BMI, reduced 25(OH)D, elevated IgG, and increased IL-6 as independent PN predictors (AUC = 0.998).
Conclusions:
- Older age, higher BMI, vitamin D deficiency, elevated IgG, and increased IL-6 levels are significant independent risk predictors for PN in MM patients.
- Early assessment of these parameters can identify high-risk individuals.
- Targeted preventive strategies and personalized nursing interventions can reduce PN incidence and improve overall clinical outcomes in MM patients.
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