The significance of autologous hematopoietic stem cell transplantation on immunoglobulin reconstitution and prognosis in elderly patients with multiple myeloma

Figures & data

Table 1. Clinical information in elderly patients with MM.

Factors	MM group (n = 93)
Median age (years, range)	65.0, 60.0–74.0
Gender
Male (n,%)	55, 59.1
Female (n,%)	38, 40.9
Myeloma subtype
IgG (n,%)	46, 49.5
IgA (n,%)	20, 21.5
Light chain (n,%)	16, 17.2
Others (n,%)	11, 11.8
ISS stage
І	32, 34.4
II	29, 31.2
III	32, 34.4
ECOG score
0 (n,%)	83, 89.2
1 (n,%)	10, 10.8
Cytogenetic risk
High (n,%)	20, 21.5
Standard (n,%)	73, 78.5
Charlson score
≤ 2 (n,%)	82, 88.2
> 2 (n,%)	11, 11.8
LDH (U/L)	207 (108–613)
HGB (g/L)	102 (58–148)
sCR (µmol/L)	171 (62–502)
sCa (mmol/L)	2.32 (1.40–3.49)

Note: MM, multiple myeloma; ISS, International Staging System, ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; HGB, haemoglobin; sCR, serum creatinine; sCa, serum calcium.

Figure 1. The number of death, relapse, or reconstitution of polyclonal Igs.

Table 2. Comparison of clinical indicators between Ig reconstitution group and Immunoparesis group.

Factors	Ig reconstitution group (n = 39)	Immunoparesis group (n = 28)	P value
Age (years)	65.18 ± 2.88	65.57 ± 4.02	0.643
Gender			0.393
Male (n,%)	21, 53.8	18, 64.3
Female (n,%)	18, 46.2	10, 35.7
Myeloma subtype			0.203
IgG (n,%)	22, 56.4	15, 53.6
IgA (n,%)	9, 23.1	2, 7.1
Light chain (n,%)	4, 10.3	5, 17.9
Others (n,%)	4, 10.3	6, 21.4
ISS stage			0.025
І	22, 56.4	8, 28.6
II	11, 28.2	8, 28.6
III	6, 15.4	12, 42.9
ECOG score			0.793
0 (n,%)	34, 87.2	25, 89.3
1 (n,%)	5, 12.8	3, 10.7
Cytogenetic risk			0.200
High (n,%)	5, 12.8	7, 25.0
Standard (n,%)	34, 87.2	21, 75.0
Charlson score			0.119
≤ 2 (n,%)	33, 84.6	27, 96.4
> 2 (n,%)	6, 15.4	1, 3.6
LDH (U/L)	210.1 ± 84.52	257.0 ± 91.12	0.034
HGB (g/L)	107.3 ± 18.16	91.39 ± 18.85	0.001
sCR (µmol/L)	153.6 ± 45.73	184.6 ± 39.07	0.005
sCa (mmol/L)	2.22 ± 0.41	2.49 ± 0.41	0.009

Note: MM, multiple myeloma; ISS, International Staging System, ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; HGB, haemoglobin; sCR, serum creatinine; sCa, serum calcium.

Figure 2. The predictive roles of Ig. (A) The K-M curve was plotted to analyze the OS outcome. (B) Patients in the immunoparesis group had poor PFS outcomes.

Table 3. Cox analysis of independent indicators for prognosing long-term outcome.

Factors	OR	95% CI	P value
Ig reconstitution	6.243	1.467–26.568	0.013
Age (years)	0.893	0.322–2.482	0.829
Gender	1.736	0.567–5.311	0.334
Myeloma subtype
IgG (n,%)			0.864
IgA (n,%)	0.540	0.121–2.419	0.421
Light chain (n,%)	0.953	0.121–7.516	0.964
Others (n,%)	0.863	0.126–5.903	0.881
ISS stage
І			0.018
II	1.808	0.451–7.244	0.403
III	5.476	1.534–19.544	0.009
ECOG score	1.634	0.298–8.957	0.571
Cytogenetic risk	2.386	0.582–9.779	0.227
Charlson score	1.113	0.208–5.967	0.901
LDH (U/L)	0.325	0.083–1.274	0.107
HGB (g/L)	3.374	0.739–15.393	0.116
sCR (µmol/L)	0.728	0.203–2.608	0.626
sCa (mmol/L)	3.777	0.977–14.597	0.054

Note: Ig, immunoglobulin; ISS, International Staging System, ECOG, Eastern Cooperative Oncology Group; LDH, lactate dehydrogenase; HGB, haemoglobin; sCR, serum creatinine; sCa, serum calcium.