Medical & Clinical Research

Author(s): Lohuwa Mamudu*, Chris P Tsokos and Otunuga Oluwaseun E

Though multiple myeloma cancer (MMC) remains incurable, research into improving the therapeutic strategy has increased dramatically in recent years. But it is unclear if sustained improvements have been achieved. We studied the survival times of 48 patients diagnosed and treated with alkylating agents. The semi-parametric Cox proportional hazard model was employed to examine the survival probability taking into account the sixteen risk factors presumed to be contributing to the survival times. A careful and rigorous assessment of the risk factors based on the AIC of the stepwise selection technique revealed seven risk factors, and one interaction term are statistically significantly contributing to the survival times. They are blood urea nitrogen (BUN)/serum creatinine, white blood cells (WBC), Bence Jone protein in the urine (BJPU), fractures, proteinuria, gender, platelets, and the interaction of infections and serum calcium. The final Cox-PH model was well-validated and satisfied the key assumptions. The identified risk factors are rank according to the prognostic effect on the survival time based on the hazard ratio. Blood urea nitrogen (BUN)/serum creatinine was the greatest prognostic factor (most contributing factor, and highly negatively related to the MMC deaths or survival times), followed by white blood cells (WBC), and normal platelet was found to be the minimum prognostic factor (least contributing factor to MMC death or survival times). This study offers prognostic and therapeutic significance for further enhancement in the treatment strategy of the multiple myeloma cancer disease.