RESUMO
OBJECTIVE: To evaluate the predictive value of pre-treatment serum uric acid (sUA) level for the prognosis of newly diagnosed multiple myeloma (NDMM) patients. METHODS: The NDMM patients admitted to our center from January 2014 to December 2018 were analyzed retrospectively, and 94 patients among them who were initially treated with bortezomib-based chemotherapy for at least 4 cycles were included in this study. Clinical characteristics, laboratory data and follow-up information were collected, and the predictive value of sUA on the overall survival (OS) of NDMM was evaluated by using receiver operating characteristic (ROC) curve based on the patient's pre-treatment sUA level and the survival status at the end of follow-up, and the correlation of the sUA level with patient's clinical, laboratory characteristics and overall survival (OS) was further analyzed. The univariate and multivariate Cox proportional-hazards model were used to identify the potential factors affecting OS. RESULTS: ROC analysis showed that the area under the curve for predicting OS in NDMM patients with sUA level was 0.702 (P<0.001), and the optimal cut-off value was 455.4 µmol/L. Compared to patients with low sUA (<455.4 µmol/L), patients with higher sUA (≥455.4 µmol/L) were more likely to have international staging system (ISS) stage III disease, beta2-microglobulin (ß2-MG) ≥5.5 mg/L, serum creatinine (sCr) ≥177 µmol/L, serum corrected calcium (cCa) ≥2.75 mmol/L, urea nitrogen (BUN) ≥1×upper limit of normal, and high-risk cytogenetic abnormality (all with P<0.001). At a median follow-up of 22.5 months, the OS of NDMM with lower sUA was significantly better than higher sUA (median OS: not reached vs 32 months, P=0.003). Univariate COX regression analysis identified that age ≥60 years old, ISS stage III, sUA ≥455.4 µmol/L, ß2-MG ≥5.5 mg/L, cCa ≥2.75 mmol/L were risk factors affecting OS. The multivariate COX regression analysis that only age ≥60 years old (HR=2.317, 95%CI: 1.015-5.288, P=0.045) and sUA ≥455.4 µmol/L (HR=2.785, 95%CI: 1.054-7.361, P=0.039) were independent risk factors affecting OS. CONCLUSION: Pre-treatment sUA level is a potential biomarker for the prognosis evaluation in NDMM patients, which deserves a further exploration and verification.
