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4732 Survival Trends and Prognostic Factors of Patients with Newly Diagnosed Multiple Myeloma Accompanied with Extramedullary DiseaseClinically Relevant Abstract

Program: Oral and Poster Abstracts
Session: 652. Multiple Myeloma: Clinical and Epidemiological: Poster III
Hematology Disease Topics & Pathways:
Plasma Cell Disorders, Diseases, Lymphoid Malignancies
Monday, December 11, 2023, 6:00 PM-8:00 PM

Jing Wang1*, Na Shen1*, Xuxing Shen1*, Run Zhang1*, Yuan Jin1*, Jianyong Li, MD2 and Lijuan Chen3*

1Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
2Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
3Department of Hematology, Jiangsu Province Hospital and The First Affiliated Hospital with Nanjing Medical University, Nanjing, China

Extramedullary disease (EMD) is an unusual event in patients with MM. This study aimed to assess the prognostic impact of EMD and develop an EMD-based risk model to estimate the survival of patients with newly diagnosed multiple myeloma (NDMM). A total of 518 patients were enrolled in this study, of which 121 presented with EMD at the initial diagnosis. Patients were divided into non-EMD, extramedullary-bone-related (EM-B), and extramedullary-extraosseous (EM-E) groups. Clinical characteristics were compared using the chi-squared test or Fisher’s exact test. Survival curves were plotted using the Kaplan-Meier method, and a nomogram was constructed based on the Cox proportional hazards model. Compared to patients without EMDs, patients with EM-E were younger (P=0.028), and those with EM-B had less renal damage (P<0.001). The EM-E group had the worst progression-free survival (PFS) and overall survival (OS). In addition, patients with multiple sites of EMD invasion or high Ki67 expression had poor OS. Lenalidomide-based treatment showed the worst outcome, and autologous stem cell transplantation (ASCT) remarkably improved the survival of patients with EMD. A prognostic model (MM prognostic index, MM-PI) comprising lactate dehydrogenase (LDH), circulating plasma cells (CPC), del(17p), and type of extramedullary involvement was developed, and a 4-factor nomogram. In conclusion, we established a risk model incorporating extramedullary disease that provides accurate and individualized survival estimates for patients with NDMM.

Disclosures: Chen: Takeda Pharmaceutical Company Limited.: Honoraria, Research Funding.

*signifies non-member of ASH