Impact of severe immunoparesis degree and duration on progression-free survival in newly diagnosed multiple myeloma: a retrospective cohort study of 258 patients.

OBJECTIVE: To investigate the relationship between the degree and duration of immunoparesis at diagnosis and poor prognosis in patients with newly diagnosed multiple myeloma (NDMM). METHODS: A retrospective analysis was conducted on the clinical data of 258 patients with NDMM, including the status and duration of immunoparesis and the influence of other factors on prognosis. RESULTS: 91.5% of NDMM had varying degrees of immunoparesis. The median progression-free survival (PFS) was significantly shorter in the severe immunoparesis group than in the non-severe immunoparesis group (25 months vs. 34 months, P = 0.0149). The median PFS was significantly shorter in the groups with severe immunoparesis lasting ≥ 3, ≥ 6, and ≥ 12 months than in the group with non-severe immunoparesis lasting (P ≤0.05). Osteolytic lesions, 17p deletion/mutation, hemoglobin < 85g/L, and severe immunoparesis lasting ≥ 12 months were independent poor prognostic factors for PFS (all P < 0.05). Circulating plasma cells ≥ 2% and osteolytic lesions were independent poor prognostic factors for overall survival (OS) (all P < 0.05). CONCLUSION: Immunoparesis at diagnosis and its duration are poor prognostic factors for PFS in patients with NDMM.