Evaluation of Prognostic Significance of İnternational Scoring System According to Glomerular Filtration Rate in Newly Diagnosed Multiple Myeloma Patients Eligible for Autologous Stem Cell Transplantation

Objective: The prognosis of multiple myeloma (MM) patients is highly heterogeneous. The aim of this study is to determine the impact of patients’ renal function on the prognostic performance of International Staging System (ISS). In addition, we aimed to evaluate the results of survival of patients with ISS and normal renal function, ISS and abnormal renal function with this study.

Materials and methods: Two hundred and four patients with newly diagnosed MM who received an autologous stem cell transplantation (ASCT) after induction chemotherapy in our tertiary care center between the years of 2001 and 2018 were evaluated.

Results: There were 153 (75%) MM patients who had GFR ≥60 ml/min, 51 (25%) MM patients who had glomerular filtration rate (GFR) <60 ml/min at the time of diagnosis in this study. There was a strong correlation between ISS stage and GFR. The ISS staging was higher in patients who had GFR <60ml/min than patients who had GFR ≥60 ml/min (p<0.001). Patients with GFR <60 ml/min were significantly higher in ISS III group than ISS I and II (p<0.001).

Conclusion: In conclusion, this study showed that ISS provides significant prognostic information in MM patients with GFR ≥60 ml/min at the diagnosis. However, in patients with impaired renal function at the time of diagnosis, B2-microglobulin (B2M) may not be a good prognostic indicator since it may be affected by renal dysfunction as well as tumor burden.