The prognostic role of whole blood viscosity and bone marrow fibrosis in predicting survival outcomes in new diagnosis multiple myeloma patients

Abstract

Aim: This study aimed to evaluate the prognostic role of whole blood viscosity and bone marrow fibrosis in predicting survival outcomes and relationships with prognostic predictors, such as international scoring system albumin levels, beta2-microglobulin, total protein, albumin, and lactate dehydrogenase in newly diagnosed mult & imath;ple myeloma patients. Material and Methods: We retrospectively evaluated 108 patients diagnosed with mult & imath;ple myeloma between 2015-2022. Whole blood viscosity was calculated using the Simone formula, incorporating the hematocrit and total protein values. Bone marrow fibrosis was graded as mild '2', significant '3', or advanced. Comparisons of grade 0-3 bone marrow fibrosis and high-low calculated whole blood viscosity groups in terms of overall survival were conducted using the Kaplan-Meier survival curve and log-rank test. Results: The median follow-up period was 16 months, and 57.4% of patients died during follow-up. The median overall survival was 26 months. The calculated whole blood viscosity (c-WBV) value predicted mortality with 88.7% sensitivity and 45.7% specificity. Patients with a high c-WBV (>= 17.14 208 mPa-s) had significantly lower one-and two-year survival rates than those with a low c-WBV (<17.14 208 mPa-s) (p<0.001). Bone marrow fibrosis was inversely related to survival, with higher grades being associated with lower survival rates. The two-year expected survival time, respectively, bone marrow fibrosis 2 and 3 was determined to be 56.7%, 43.6%, 41.4%, and 23.3% (p<0.001). Discussion: This study highlights the potential of whole blood viscosity and bone marrow fibrosis as prognostic markers in patients with newly diagnosed multiple myeloma patients. Incorporating these parameters into the existing staging systems may enhance prognostic prediction and guide treatment decisions. Further prospective studies are warranted to validate these findings and explore the mechanistic links between whole blood viscosity, bone marrow fibrosis, and MM pathophysiology.