Serum platelet factor 4 is a promising predictor in newly diagnosed patients with multiple myeloma treated with thalidomide and VAD regimens

Figures & data

Table 1. Clinical characteristics of the 122 ND MM patients.

Clinical features	ND cases(n = 122)	Clinical features	ND cases(n = 122)
Sex		Del17p
Male	64	Yes	16
Female	58	No	106
Age (year)	56.5(44–73)	Bence-Jone protein	39
WBC (×10^9/L)	5.5(3.1–13.2)	LDH↑	34
Hb (g/L)	93(52–121)	MM cell >10%	122
PLT (×10^9/L)	190(28–328)	ESR↑	93
Subtype		Bone lesions (lytic lesions, pathologic fractures or severe osteopenia)	93
IgG type	65
IgA type	20
IgM type	0	Albumin < 35 g/L	55
Light chain type	17	Albumin ≥ 35 g/L	67
Non-secretory type	20	ISS Criteria
Durie-Salmon Criteria		I	34
I	29	II	46
II	53	III	42
III	40	Treatment response(after two of chemotherapy)
Glb (>30 g/L)	102	Yes*	58
Renal failure (serum creatinine ≥2 mg/dl)	51	No	64

*Yes means that MM patients gained CR&VGPR after two courses of chemotherapy. WBC: white blood cell; Hb: hemoglobin; PLT: platelet; Glb: globulin; LDH: lactate dehydrogenase; ESR: erythrocyte sedimentation rate; ND: newly diagnosed.

Table 2. Serum PF4 concentration with respect to the clinical characteristics at diagnosis.

Clinical characteristics	Number of cases	PF4 serum concentration (median ± interquartile range)	Mean Rank	P value
Gender
Male	64	634.8 ± 100.7	31.31	0.927
Female	58	624.5 ± 125	31.73
Age
≥60y	53	631.9 ± 110.4	31.54	0.988
<60y	69	634.9 ± 95.1	31.47
β2-microglobulin
<3.5 mg/dl	47	792.2 ± 194.2	44.46	0.0006
≥5.5 mg/dl	39	604.8 ± 24.9	19.71
3.5–5.5 mg/dl	36	658.4 ± 38.7	27.00
LDH↑	34	634.8 ± 148.6	30.18	0.755
LDH normal	88	633 ± 73.7	31.89
ISS
I	47	779.8 ± 195.4	44.11	0.003
II	36	684.9 ± 114.9	35.94
III	39	604.8 ± 24.9	19.71
Del17p
Yes	16	585.9 ± 56.4	15.67	0.001
No	106	694.9 ± 124.4	35.30
Remission induction (two courses of chemotherapy)
Yes*	58	757.3 ± 149.8	41.25	0.00011261
No	64	613.5 ± 46.6	23.47
Albumin < 35 g/L	55	639.1 ± 149.5	34.36	0.305
Albumin ≥ 35 g/L	67	624.1 ± 52.7	29.57
Hb
>100 g/L	43	634.2 ± 55.3	30.67	0.962
85–100 g/L	44	634.8 ± 72.3	32.04
<85 g/L	35	614.9 ± 189	31.90
Cr < 2.0 mg/dL	71	754.6 ± 146.6	17.62	0.0005
Cr ≥ 2.0 mg/dL	51	604.6 ± 39.8	38.61

*Yes means that MM patients gained CR&VGPR after two courses of chemotherapy. LDH: lactate dehydrogenase; Hb: hemoglobin; Cr: creatinine.

Figure 1. Lower serum concentration of platelet factor 4(<median serum concentration) associated with an unfavorable overall survival.

Table 3. Univariate analysis of OS in MM patients.

Variable	Median overall survival (month)	Chi-square	P value
Gender
Male	26.00	0.028	0.866
Female	23.00
Age
≥60y	25.00	0.076	0.783
<60y	26.00
β2-microglobulin
<3.5 mg/dl	28.00	6.604	0.0061
≥5.5 mg/dl	20.00
3.5–5.5 mg/dl	21.00
LDH↑	21.00	0.870	0.351
LDH normal	25.00
ISS
I	28.00	2.563	0.278
II	26.00
III	20.00
Del17p
Yes	13.00	7.725	0.005
No	26.00
Remission induction(two courses of chemotherapy)
Yes*	28.00	8.361	0.004
No	21.00
Albumin < 35 g/L	26.00	0.261	0.610
Albumin ≥ 35 g/L	25.00
Hb			0.983
>100 g/L	26.00	0.035
85–100 g/L	21.00
<85 g/L	25.00
Cr < 2.0 mg/dL	21.00	5.902	0.015
Cr ≥ 2.0 mg/dL	27.00

*Yes means that MM patients gained CR&VGPR after two courses of chemotherapy. LDH: lactate dehydrogenase; Hb: hemoglobin; Cr: creatinine.

Table 4. Multivariate analysis of OS in MM patients.

			95.0% CI
Variable	p value	RR	Lower	Upper
Age	0.897	0.955	0.473	1.928
Gender	0.431	0.701	0.290	1.695
Lactate dehydrogenase	0.259	1.655	0.690	3.969
Albumin	0.303	1.515	0.687	3.339
Del17p	0.0296	1.834	0.588	5.719
Hemoglobin	0.723	0.844	0.332	2.149
PF4	0.006	0.023	0.009	0.092
β2-microglobulin	0.0393	1.044	0.560	1.946
Creatinine	0.255	0.628	0.282	1.399
ISS	0.274	0.690	0.355	1.342
Treatment response(after two courses of chemotherapy)	0.031	1.223	0.537	2.784