A prognostication system based on clinical parameters and [18F]-FDG PET/CT in patients with newly diagnosed multiple myeloma

Abstract

Purpose: This study aimed to assess prognosis of patients with newly diagnosed multiple myeloma (NDMM) by combining [¹⁸F]-FDG positron emission tomography (PET)/CT parameters and clinical indices.

Methods: Clinical data and PET/CT parameters of 133 NDMM patients were retrospectively analyzed for associations between clinical indices and PET/CT parameters. Independent predictors of progression-free survival (PFS) and overall survival (OS) were determined. A new prognostic prediction system (NPPS) was constructed based on our findings. Prediction effectiveness was compared among the NPPS, International Staging System (ISS), Revised ISS (R-ISS), and R2-ISS.

Results: Prevalence of elevated β2-microglobulin, serum creatinine (sCr), serum calcium (sCa), and C-reactive protein concentrations was higher in patients with higher SUVmax (≥ 5.3). Prevalence of elevated sCa, sCr, and extramedullary disease (EMD) was higher in patients with a higher number of focal lesions (≥ 10). SUVmax, serum free-light chain (sFLC) ratio, and EMD were independent predictors of PFS and OS. The NPPS used SUVmax, sFLC ratio, and EMD could effectively predict OS and was more effective at prognostication than the ISS, R-ISS, and R2-ISS.

Conclusions: [¹⁸F]-FDG PET/CT parameters play a significant role in predicting prognosis in NDMM patients. The NPPS based on SUVmax, sFLC ratio, and EMD outperformed the ISS, R-ISS, and R2-ISS in prognostication.

Keywords: Clinical parameters; Multiple myeloma; PET/CT; Prognosis; Staging.