Risk nomogram for assessing renal recovery in patients with newly diagnosed multiple myeloma-related renal impairment

IF 2.5 4区医学 Q3 ONCOLOGY

Current Problems in Cancer Pub Date : 2023-08-01 DOI:10.1016/j.currproblcancer.2023.100962

Shaobo Li , Min Zhang , Jin Liu , Shaojun Liu , Chen Zhu , Da Shang , Yi Guan , Qian Wang

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引用次数: 0

Abstract

To determine risk factors affecting renal recovery in newly diagnosed multiple myeloma (NDMM) patients with renal impairment (RI) and establish a risk nomogram. This multi-center, retrospective cohort study included 187 NDMM patients with RI, 127 of whom were admitted to Huashan Hospital and assigned to the training cohort and 60 were admitted to Changzheng Hospital and assigned to the external validation cohort. The baseline data of the 2 cohorts were compared, and survival and renal recovery rates were analyzed. Independent risk factors affecting renal recovery were determined by binary logistic regression analysis, and a risk nomogram was established and subsequently tested in the external validation cohort. Results: The median overall survival (OS) improved in patients who achieved renal recovery etc within 6 courses of MM directed treatment compared with patients without renal recovery. Median time to renal recovery was 2.65 courses, and the cumulative renal recovery rate during the first 3 courses was 75.05%. Involved serum free light chain (sFLC) ratio of >120 at diagnosis, time from renal impairment to treatment > 60 days, and a hematologic response without a very good partial remission (VGPR) or better resulted as independent risk factors for renal recovery during the first 3 courses. The established risk nomogram had good discriminative ability and accuracy. Involved sFLC was a key factor affecting renal recovery. Starting treatment as soon as possible after detecting RI and achieving deep hematologic remission during the first 3 courses of treatment helped achieve renal recovery and improve prognosis.

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评估新诊断的多发性骨髓瘤相关肾损伤患者肾功能恢复的风险列线图。

确定影响新诊断的多发性骨髓瘤（NDMM）肾功能损害（RI）患者肾功能恢复的风险因素，并建立风险列线图。这项多中心回顾性队列研究包括187名患有RI的NDMM患者，其中127人入住华山医院并被分配到训练队列，60人入住长征医院并被指定到外部验证队列。比较两组患者的基线数据，并分析生存率和肾恢复率。通过二元逻辑回归分析确定影响肾功能恢复的独立风险因素，并建立风险列线图，随后在外部验证队列中进行测试。结果：与未肾功能恢复的患者相比，在MM指导的6个疗程内实现肾功能恢复等的患者的中位总生存率（OS）有所提高。肾功能恢复的中位时间为2.65个疗程，前3个疗程的累积肾功能恢复率为75.05%。诊断时血清游离轻链（sFLC）比率>120，从肾损伤到治疗时间>60天，在前3个疗程中，没有非常好的部分缓解（VGPR）或更好的血液学反应作为肾恢复的独立风险因素。所建立的风险列线图具有良好的判别能力和准确性。sFLC是影响肾功能恢复的关键因素。在检测到RI后尽快开始治疗，并在前3个疗程中实现血液学的深度缓解，有助于实现肾脏恢复和改善预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cancer 医学-肿瘤学

CiteScore

5.10

自引率

0.00%

发文量

审稿时长

15 days

期刊介绍： Current Problems in Cancer seeks to promote and disseminate innovative, transformative, and impactful data on patient-oriented cancer research and clinical care. Specifically, the journal''s scope is focused on reporting the results of well-designed cancer studies that influence/alter practice or identify new directions in clinical cancer research. These studies can include novel therapeutic approaches, new strategies for early diagnosis, cancer clinical trials, and supportive care, among others. Papers that focus solely on laboratory-based or basic science research are discouraged. The journal''s format also allows, on occasion, for a multi-faceted overview of a single topic via a curated selection of review articles, while also offering articles that present dynamic material that influences the oncology field.