Hematopoietic Score for the Prognostic Evaluation of Multiple Myeloma Patients Undergoing First-Line Treatment With A Bortezomib-Based Regimen

Abstract Background: It is very important to evaluate the prognosis of multiple myeloma (MM) patients before starting treatment. Although hematopoietic status may have a significant impact on patient survival, it has not received sufficient attention in current clinical practice. Methods: This was a retrospective study of 328 newly diagnosed MM patients received first-line treatment with a bortezomib-based regimen. The effects of hematopoietic factors, including hemoglobin (Hgb) levels, mean corpuscular volume (MCV), and platelet count (Plt) on the prognosis of the patients were analysed. Results: Hgb<100 g/L, MCV>99.1fL and Plt<150×109/L significantly affect the progression-free survival (PFS) and overall survival (OS) of MM patients, each of the above factors was assigned a value of 1 to generate a hematopoietic score. According to the results, 93 (28.4%), 103 (31.4%), 90 (27.4%) and 42 (12.8%) patients had a score of 0, 1, 2, 3, respectively. The median PFS were 38.7, 55.9, 23.9 and 16.7 months, respectively (P<0.001), and the median OS were not reached (NR), 68.4months, 53.6 and 33.2 months, respectively (P<0.001). Multivariable analysis showed that hematopoietic score (2-3 vs 0-1, HR, 1.64) and bone marrow plasma cell percentage (>30%, HR, 1.54) are independent prognostic predictors for PFS; age (≥70 years, HR, 1.67), hematopoietic score (2-3 vs 0-1, HR, 1.60), serum creatinine level (>177umol/L, HR, 2.15) and bone marrow plasma cell percentage (>30%, HR, 1.81) are independent prognostic predictors of OS. Conclusions: This study suggests that the hematopoietic score can be used to evaluate the prognosis of newly treated MM patients in the era of new drugs. However, there is still a need to enlarge the number of cases and carry out prospective research to validate this conclusion.