The Pattern of Response to Chemotherapy and Prognosis in Patients with Multiple Myeloma

Abstract

Durie et al. classified patients with multiple myeloma into 4 groups (A, B, C, D) according to their pattern of response to chemotherapy. In our study, 87 of 120 patients were classified as pattern A, and there was no significant difference in the median survival duration among the groups; 34 months in A, 31 months in B, 78 months in C, and 43 months in D. Therefore, we classified the patients in pattern A into 4 subgroups; Al: a high M component at diagnosis and low tumor regression rate (<50%), A2: a high M component and high tumor regression rate (50%≥), A3: a low M component and low tumor regression rate (<50%), A4: a low M component and high tumor regression rate (50%≥). There was no significant difference in the number of patients; A1: 12, A2: 27, A3: 23, A4: 25. The median survival duration was 34 months in A1, 22 months in A2, 103 months in A3 and 21 months in A4. The median survival was longer in A1 than in A2, and it was significantly longer in A3 than in A2 or A4 (p<0.05). As above, the tumor regression rate after chemotherapy is an important prognostic factor equal to the M component at diagnosis in patients with multiple myeloma. Additionally, the percentage of myeloma cells in bone marrow at diagnosis are the good indicator for the prediction of response pattern of multiple myeloma to chemotherapy.