[Values of Serum Ferritin, Folic Acid and Vitamin B12 in Treatment of Multiple Myeloma with Bortezomib Combined with Chemotherapy].

Objective: To investigate the value of serum ferritin, folic acid and vitamin B₁₂ in the treatment of multiple myeloma (MM) with bortezomib combined with chemotherapy.

Methods: Clinical data of 40 MM patients admitted to our hospital from January 2020 to August 2022 and 40 hematology outpatients during the same period were reviewed. All MM patients were treated with bortezomib combined with chemotherapy. The diagnostic efficacy of serum ferritin, folic acid and vitamin B₁₂ on MM was analyzed by ROC curve. The changes of serum ferritin, folic acid and vitamin B₁₂ in MM patients before and after treatment were compared. According to the mean values of serum ferritin, folic acid and vitamin B₁₂, patients were divided into high and low expression groups, and the survival of patients between the groups was compared.

Results: Before treatment, the levels of serum ferritin and vitamin B₁₂ in MM patients were significantly higher than those in control group, while folic acid was lower (all P <0.001). The area under the curve (AUC) of MM patients diagnosed with ferritin, folic acid and vitamin B₁₂ were 0.928, 0.843 and 0.867, the specificity was 100%, 67.50% and 72.50%, and the sensitivity was 80.00%, 95.00% and 87.50%, respectively. After 4 cycles of chemotherapy, there were 9 cases of complete remission (CR), 19 cases of very good partial remission (VGPR), 6 cases of PR, 4 cases of stable disease (SD) and 2 cases of progression disease (PD) in 40 MM patients. In CR group, ferritin and vitamin B₁₂ decreased but folic acid increased after treatment compared with before treatment (all P < 0.05). The overall survival (OS) rates of patients in low expression group of ferritin and vitamin B₁₂ were significantly higher than those in high expression group (both P < 0.01). The OS rate of patients in high expression group of folic acid was significantly higher than that in low expression group (P < 0.01). Cox regression analysis showed that ferritin was an independent prognostic factor for MM patients (HR=8.850, 95%CI : 2.267-34.553, P =0.002).

Conclusion: Serum ferritin, folic acid and vitamin B₁₂ have some auxiliary value in the diagnosis and efficacy evaluation of MM, and ferritin is an independent prognostic factor for MM.