Objective: To investigate the significance of a new risk stratification model (R2-ISS) in evaluating the prognosis of newly diagnosed multiple myeloma (MM).
Methods: Clinical data of 116 newly diagnosed MM patients admitted to Lanzhou University Second Hospital from June 2012 to March 2021 were retrospectively analyzed. According to R2-ISS, these patients were divided into four groups: low risk, low-intermediate risk, intermediate-high risk, and high risk. The significance of R2-ISS on prognosis of the patients was analyzed.
Results: Survival analysis showed that R2-ISS was associated with progression-free survival (PFS) (P=0.042) and overall survival (OS) (P=0.014). Cox univariate analysis showed that lactate dehydrogenase, serum calcium, serum creatinine, β2-microglobulin, ISS, R-ISS, R2-ISS, t(4;14), and autologous hematopoietic stem cell transplantation (ASCT) were the influencing factors of OS in newly diagnosed MM patients (all P<0.05). Cox multivariate analysis showed that R-ISS, R2-ISS, and ASCT were independent risk factors affecting OS (all P<0.05). In addition, survival analysis of patients with different R2-ISS showed that ASCT improved PFS and OS.
Conclusion: R2-ISS has prognostic value for newly diagnosed MM patients, while ASCT can improve the prognosis of patients with different R2-ISS.
题目: 全新风险分层模型R2-ISS对初诊多发性骨髓瘤的预后评估价值.
目的: 探讨全新风险分层模型R2-ISS在评估初诊多发性骨髓瘤（MM）患者预后中的意义。.
方法: 回顾性分析2012年6月至2021年3月兰州大学第二医院收治的116例初诊MM患者临床资料，按R2-ISS将患者分为低危、中低危、中高危和高危共4组，分析R2-ISS对初诊MM患者预后的影响。.
结果: 生存分析结果显示，R2-ISS与患者无进展生存期（P=0.042）及总生存期（P=0.014）相关。Cox单因素分析结果显示，乳酸脱氢酶、血钙、血肌酐、β2-微球蛋白、ISS、R-ISS、R2-ISS、t(4;14)、自体造血干细胞移植（ASCT）是初诊MM患者总生存期的影响因素（均P<0.05）。Cox多因素分析结果显示，R-ISS、R2-ISS及ASCT是影响患者总生存期的独立危险因素（均P<0.05）。此外，对不同R2-ISS患者的生存分析结果显示，ASCT改善了患者的无进展生存期、总生存期（均P<0.05）。.
结论: R2-ISS对初诊MM患者具有预后判断价值，ASCT可改善不同R2-ISS患者的生存预后。.
Keywords: R2-ISS; autologous hematopoietic stem cell transplantation; multiple myeloma; prognosis; risk stratification.