Influence of Kidney Histology on Prognosis in Multiple Myeloma

was 39.1% in stage I, 41.4% in II, and 18.4% in III. Patients with standard and high cytogenetic risk were 57.5% and 37.9%. More than a half of patients (59.8%) were treated with thalidomide induction. Patients with low and high BM FDG uptake were 69 and 18. High cytogenetic risk (RR 8.20, P1⁄40.018), anemia (RR 5.07, P1⁄40.056), BM plasma cells more than 30% (HR 3.68, P1⁄40.050) and extramedullary disease (EMD; RR 7.72, P1⁄40.017) were associated with high uptake. Three year progression free survival rate was 52.8% in low group and 31.8% in high group (P1⁄40.3916). Overall survival (OS) rate for 5 years in low group was 54.7%, while it was 45.4% (HR 1.976, 95% CI 0.26-0.75, P1⁄40.0538) in high group. To enhance homogeneity of the study population, we run subgroup analyses of patients with thalidomide based induction regimen (n1⁄448). Patients with low and high uptake were 34 and 14, respectively. Five year OS in high group was 48.5% (HR 2.41, 95% CI 0.1762-0.7395, P1⁄40.043), while it was 61.0% in low group. ECOG 2 (HR 2.78, P1⁄40.045), BM plasma cells 30% (HR 3.98, P1⁄40.005), ISS stage III (HR 4.18, P1⁄40.013), elevated LDH (HR 1.33, P1⁄40.004) and 2 microglobulin (HR 4.43, P1⁄40.019). Autologous hematopoietic stem cell transplantation (HR 0.23, P1⁄40.020) and the absence of EMD (HR 0.36, P1⁄40.049) were related with better prognosis. Conclusion: Initial high BM FDG uptake by direct visual assessment in MM showed correlations with poor prognosis and more aggressive disease. This finding could make possible simple and fast prediction of prognosis in MM.