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Outcome and characteristics of nonsecretory multiple myeloma compared with secretory multiple myeloma: a retrospective multicenter study from China

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机构： [1]Peking University People’s Hospital, Peking University Institute of Hematol‑ ogy, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, P.R. China [2]Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, P.R. China [3]Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, P.R. China [4]Department of Hematology, The Afliated Hospital of Qingdao University, Qingdao, Shan‑ dong, P.R. China [5]Bone Marrow Transplantation Center, the First Afliated Hos‑ pital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China [6]Department of Hematology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China [7]Department of Hematology, Jiangsu Province Hospital, The First Afliated Hospital With Nanjing Medical University, Nanjing, Jiangsu, P.R. China [8]Department of Hematology, Xijing Hospital, Air Force Medical University, Xi’an, Shanxi, P.R. China [9]Department of Hematol‑ ogy, The First Afliated Hospital of Zhengzhou University, Zhengzhou, Henan, P.R. China [10]Haematology Department of Shengjing Hospital, China Medical University, Shenyang, Liaoning, P.R. China [11]Department of Hematology, The Afliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, P.R. China [12]Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, P.R. China [13]Department of Hematology, The First Afliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China [14]Department of Hematology, Yijishan Hospital, The First Afliated Hospital of Wannan Medical College, Wuhu, Anhui, P.R. China [15]Department of Hematology, the Afliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, P.R. China [16]Department of Hematology, People’s Hospital of Gansu Province, Lanzhou, Gansu, P.R. China [17]The First Afliated Hospital of Guangxi Medical University, Nanning, Guangxi, P.R. China [18]Depart‑ ment of Hematology, Tianjin Medical University General Hospital, Tianjin, P.R. China [19]Department of Hematology, Myeloma & Lymphoma Center, Shanghai Changzheng Hospital, Naval medical University, Shanghai, P.R. China.

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关键词： Multiple myeloma Non secretory Clinical feature FLC Prognosis feature

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Nonsecretory multiple myeloma (NSMM) is a rare type of multiple myeloma (MM). Few studies have described the clinical features and outcomes of NSMM in novel agents. Additionally, the prognostic characteristics have remained controversial in recent years.To investigate the clinical and prognostic features of NSMM and explore the prognostic value of involved free light chain (FLC) levels in NSMM patients in the Chinese population.We retrospectively enrolled 176 newly diagnosed NSMM cases between January 2005 and December 2021 from 19 clinical centers in China. The control group was selected using a 1:4 propensity score matching technique of newly diagnosed secretory MM, with age, sex and diagnosis time as the matching variables.The median age of NSMM patients was 60 years, and 22.6% of patients were classified as ISS stage 3. The ORR of the NSMM patients was 87.4%, and the CR was 65.8%. Compared to the matched secretory MM patients, more NSMM patients achieved CR after first-line treatment (65.8% vs. 36%, p = 0.000). The ORR of first-line treatment was not significantly different between NSMM and secretory MM (89.45% vs. 84.7%, p = 0.196). The first-line PFS was 27.5 m and 23 m (p = 0.063), and the median OS was 81 m and 70 months (p = 0.401). However, for CR-achieved NSMM and CR-not-achieved NSMM patients, the median PFS was 37 m vs. 16 m (p = 0.021), while the median OS showed no difference (107 m vs. 87 m, p = 0.290). In multivariate analysis, the significant factors for PFS were age ≥ 65 and ISS-3. ISS-3 was the only independent prognostic factor of OS. The iFLC ≥ 50 mg/L group had a high ORR of 97.3%, and the median PFS and OS were 48 m and NR, respectively. Compared to the matched secretory MM, the iFLC ≥ 50 mg/L group also showed more CR and longer OS (NR vs. 70 m, p = 0.006) and PFS (48 m vs. 23 m, p = 0.003).Our results revealed that Chinese NSMM patients are younger and have a higher CR but not superior survival. The subgroup of NSMM patients with iFLC ≥ 50 mg/L had better outcomes than secretory MM.© 2023. BioMed Central Ltd., part of Springer Nature.

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出版当年[2023]版：

大类 | 2 区

医学

小类 | 3 区肿瘤学

最新[2025]版：

大类 | 3 区医学

小类 | 3 区肿瘤学

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出版当年[2023]版：

Q2 ONCOLOGY

最新[2023]版：

Q2 ONCOLOGY

影响因子： 3.4 最新[2023版] 3.8 最新五年平均 3.4 出版当年[2023版] 3.8 出版当年五年平均 3.8 出版前一年[2022版]

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第一作者机构： [1]Peking University People’s Hospital, Peking University Institute of Hematol‑ ogy, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, P.R. China

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Outcome and characteristics of nonsecretory multiple myeloma compared with secretory multiple myeloma: a retrospective multicenter study from China

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