[Prognostic factors in multiple myeloma. Selection using multivariate analysis]. / Fattori prognostici nel mieloma multiplo. Selezione mediante analisi multivariata.

ABSTRACT

In order to assess the prognostic value of 15 different prognostic variables for multiple myeloma and to select the variables with the best prognostic significance, the multivariate analysis according to Cox's proportional hazard regression model was employed for a group of 80 patients followed from first diagnosis to their demise. The significant prognostic variables were bone marrow plasma cell percentage, degree of lytic bone lesions, Bence-Jones proteinuria, and haemoglobinaemia. A scoring clinical staging system was also developed, assigning the score of 1 to each of the following features bone marrow plasma cells more than 30%, lytic bone lesions of 2-3 degrees, presence of Bence-Jones proteinuria, and haemoglobinaemia less than 110 g/l. Therefore, the score for each patient ranges from 0 to 4, and the entire group of patients with multiple myeloma is subdivided into five clinical stages stage I = score 0, stage II = score 1, stage III = score 2; stage IV = score 3, stage V = score 4. Significant differences exist between both mean survivals (p less than 0.01), and between the survival curves (p less than 0.0001) within the five scoring clinical stages.