Haematologica 2003 - Supplements

models. Cytogenetic results were analyzed on a subset of patients
and analyzed for association with commonly available data.
Following is a preliminary report of the univariate analysis and
cytogenetic associations, as well as a preliminary report of
combinations of variables that predict survival.
Results: The period of study was from 1981 to 2002. We
accumulated data on 11,179 cases with initial chemotherapy and
last contact date known. 7,323 patients have died (65.5%).
Participation included 17 institutions or groups from Asia, Africa,
Europe, North America, and South America. Of all the cases,
8,690 received standard treatment, and 2,489 received high dose
therapy plus transplant as initial planned treatment, while 1,307
had a salvage transplant.
Using available data, median age was 60 years. 77% were white,
18.2% Asian, 3.6% Black, and 1.2% were other. 58% were IgG,
23.3% IgA, 3.4% IgM, 2.9% IgD, and 10.9% were light chain
only, 0.1% were biclonal and 2.1% were other. Regarding
performance status (PS), 17.4% were PS0, 40.1% PS1, 24% PS2,
13.5%PS3, and 5% PS4. Median serum M-protein level was 3.9
g/dL, hemoglobin 10.5 g/dL, platelets 221 x 10 3 /mcL, creatinine
1.1 mg/dL, B2M 3.8 mcg/mL, CRP 0.3 mg/dL, albumin 3.6 g/dL,
LDH 257.5 U/L, bone marrow plasma cell percent (PC) 40.0%.
Widespread bone disease was reported in 47.5%, 22.1% had no
bone lesions, 42.4% had 3 or more bone lesions, 24.4% had
pathologic fractures, and 33.2% had compression fractures.
Median plasma cell labeling index (PCLI) was 0.5%, and flow
cytometric S-phase was 1.6%. Plasmablastic morphology was
present in 15.5% of cases.
Cytogenetic data by karyotype was available from Arkansas,
Netherlands, ECOG, and Japan. Of 1143 patients, 36.5% had a
clonal karyotypic abnormality; 12.9% of 529 reported analyses
had del 13; 21.5% of 381 reported patients had a complex
karyotype. Clonal karyotypic abnormalities were associated with
low albumin, high B2M, calcium, creatinine, and low platelet
count. Del 13 by karyotype was associated with a high B2M,
BMPC%, high creatinine, low hemoglobin, high LDH and low
platelet count. Complex karyotype was associated with age,
higher BMPC%, calcium, creatinine, high LDH and low platelet
count.
Distribution of characteristics was relatively uniform across
centers, but occasional variation suggested there were some
population differences. For instance, younger age and lower B2M
reflected a transplant population in certain groups. To select
cutoffs for the continuous variables we graphically examined the
log rank and relative risk (RR) of survival of each factor over the
range of values. RR at specific cutoffs was as follows: age 1.6
(>=65) , albumin 1.3 (=4), BMPC 1.3
(>=33%), calcium 1.35 (>=10), CRP 1.3 (>=.8), hemoglobin 1.5
(