Table 1.
Demographics and clinical characteristics of patients with MM-alone, MM-AL and AL-alone
| MM-alone N = 658 |
MM-AL N = 106 |
AL-alone N = 151 |
P value (MM-alone vs. MM-AL) |
P value (MM-AL vs. AL-alone |
P value (overall) |
|
|---|---|---|---|---|---|---|
| Male, n(%) | 405 (61.6) | 73 (68.9) | 105 (69.5) | 0.149 | 0.909 | 0.092 |
| Age (years), median(range) | 65 (32–87) | 65 (41–82) | 63 (38–83) | 0.661 | 0.004 | 0.002 |
| ECOG performance status, n(%) | ||||||
| 0–2 | 591 (89.8) | 79 (74.5) | 123 (81.5) | < 0.001 | 0.182 | < 0.001 |
| >2 | 67 (10.2) | 27 (25.5) | 28 (18.5) | |||
| IFE, n(%) | < 0.001 | 0.093 | < 0.001 | |||
| IgG | 356 (54.1) | 43 (40.5) | 44 (29.1) | |||
| IgA | 167 (25.4) | 21 (19.8) | 28 (18.5) | |||
| IgM | 5 (0.8) | 5 (4.7) | 5 (3.3) | |||
| IgD | 20 (3.0) | 1 (0.9) | 1 (0.7) | |||
| Light chain | 86 (13.1) | 18 (17.0) | 24 (25.9) | |||
| Negative | 24 (3.6) | 17 (16.0) | 49 (32.5) | |||
| Missing | 0 (0) | 1 (0.9) | 0 (0) | |||
| BMPCs(%),median(range) | 37.5 (0–99) | 15 (1–80) | 8 (1–40) | < 0.001 | < 0.001 | < 0.001 |
| BMPC ≥ 10%, n(%) | 575 (87.7) | 87 (82.1) | 71 (47.7) | 0.115 | < 0.001 | < 0.001 |
| Organ involvement, n(%) | ||||||
| Heart | - | 97 (91.5) | 131 (86.8) | - | 0.236 | - |
| Kidney | - | 32 (30.2) | 61 (40.4) | - | 0.094 | - |
| Liver | - | 12 (11.3) | 15 (9.9) | - | 0.721 | - |
| Soft tissues | - | 73 (68.9) | 116 (76.8) | - | 0.155 | - |
| Lung | - | 0 (0) | 2 (1.3) | - | 0.234 | - |
| Peripheral neuropathy | - | 1 (0.9) | 3 (2.0) | - | 0.506 | - |
| Gastrointestinal tract | - | 3 (2.8) | 2 (1.3) | - | 0.390 | - |
| Spleen | - | 0 (0) | 1 (0.7) | - | 0.401 | - |
| Number of involved organs, median (range) | - | 2 (1–4) | 2 (1–5) | - | 0.138 | - |
| Lambda restriction, n(%) | - | 76 (71.7) | 117 (77.5) | - | 0.176 | - |
| dFLC (mg/L), median(range) | 236.9 (0.2-34886.9) | 253.25 (3.7-3500.3) | 125.1 (1.0-1691.4) | 0.566 | < 0.001 | < 0.001 |
| Serum hemoglobin(g/L), median(range) | 97.5 (35–168) | 109.5 (60–168) | 131 (71–179) | < 0.001 | < 0.001 | < 0.001 |
| Serum albumin(g/L), median(range) | 37 (16–51) | 35 (14–49) | 36 (14–62) | < 0.001 | 0.317 | < 0.001 |
| Serum alkaline phosphatase(U/L), median(range) | 72 (18–791) | 81.5 (35–700) | 80 (35-1054) | < 0.001 | 0.734 | < 0.001 |
| Serum creatine(µmol/L), median(range) | 91 (34-1185) | 94.5 (47–597) | 83 (41–515) | 0.749 | 0.027 | 0.045 |
| eGFR(mL/min/1.73m2), median(range) | 71 (3-120) | 65.5 (7-120) | 79 (7-111) | 0.952 | 0.008 | 0.003 |
| LDH(U/L), median(range) | 169 (58-3542) | 215 (98–429) | 223.5 (98-2967) | < 0.001 | 0.237 | < 0.001 |
| β2-microglobulin(mg/L), median(range) | 4.80 (1.14–58.38) | 4.45 (1.43–26.09) | 3.42 (1.51–15.14) | 0.198 | 0.003 | < 0.001 |
| NT-proBNP(pg/mL), median(range) | 187.5 (1.4->35000) | 3976.0 (42.0->35000) | 3099.0 (28.5->35000) | < 0.001 | 0.070 | < 0.001 |
| cTNT(ng/mL), median(range) | 0.011 (0.001–0.962) | 0.0815 (0.010–0.448) | 0.067 (0.003–0.655) | < 0.001 | 0.119 | < 0.001 |
| Proteinuria (g/24 h), median(range) | - | 0.72 (0.06–36.33) | 0.62 (0.03–13.88) | - | 0.690 | - |
| European 2015 modification of 2004 Mayo model, I/II/IIIa/IIIb (%) | - | 7.5/ 12.3/ 55.7/ 24.5 | 12.6/ 11.9/ 60.3/ 15.2 | - | 0.207 | - |
| Revised 2012 Mayo model, I/II/III/IV (%) | - | 3.8/ 12.3/ 37.7/ 46.2 | 13.5/ 14.9/ 40.5/ 31.1 | - | 0.015 | - |
| First-line induction therapy, n(%) | ||||||
| PI-based | 364 (55.3) | 93 (87.7) | 127 (84.1) | < 0.001 | 0.415 | < 0.001 |
| IMiD-based | 32 (4.9) | 0 (0.0) | 3 (2.0) | 0.020 | 0.144 | 0.023 |
| PI + IMiD-based | 261 (39.7) | 9 (8.5) | 9 (6.0) | < 0.001 | 0.434 | < 0.001 |
| Dara-baseda | 1 (0.2) | 3 (2.8) | 10 (6.6) | < 0.001 | 0.172 | < 0.001 |
| Othersb | 0 (0.0) | 1 (0.9) | 2 (1.3) | 0.013 | 0.779 | 0.018 |
| Cycles of induction therapy, median(range) | 8 (0.25-26) | 2 (0.25-12) | 4 (0.25-12) | < 0.001 | 0.235 | < 0.001 |
| ASCT, n(%) | 95 (14.4) | 0 (0) | 2 (1.3) | < 0.001 | 0.234 | < 0.001 |
Abbreviations: ECOG, Eastern Cooperative Oncology Group; IFE, immunofixation electrophoresis; iFLC, involved free light chain; dFLC, difference in involved and uninvolved free light chain; eGFR, estimated glomerular filtration rate; LDH, lactate dehydrogenase; BMPC, bone marrow plasmacytosis; PI, protease inhibitor; IMiD, immunomodulatory drug; Dara, daratumumab; ASCT, autologous stem cell transplantation
aDara-based: the therapeutic regimens in one patient with AL-alone was Dara plus dexamethasone, the others were combined with PI-based therapies
bIncluding supportive treatment and chemo-only therapy