Serum complement C4 may be a marker for poorer outcomes in patients with multiple myeloma (MM). These findings, from a retrospective analysis, were published in Clinical Medicine Insights: Oncology.

To test whether serum biomarkers are associated with outcomes, researchers assessed records from 72 patients with newly diagnosed MM at the First People’s Hospital of Yunnan Province in China between July 1, 2017, and January 1, 2019.

The median age at diagnosis was 59 years (range, 37 to 83), 42 participants were men, the median time from diagnosis to death was 715 days (range, 15 to 1400), and the 2-year overall survival rate was 48.6%. Based on the International Staging System, 39 patients had stage III disease, 20 had stage II, and 13 had stage I.

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At 2 years, 35 patients had survived. The survivor cohort was significantly younger (P =.039), had higher hemoglobin (P =.007) and platelets (P =.046), and had lower blood urea nitrogen (P =.046).

Using a complement C4 cutoff of 0.095 g/L, higher complement C4 was associated with higher survival probability (P =.004) and increased survival time within 2 years (median, 743 vs 180 days; P =.004).

Overall survival was associated with a bone marrow plasma cell percentage of 30.75% or higher (hazard ratio [HR], 0.171; 95% CI, 0.06-0.482; P =.001), age 67 years or older (HR, 0.191; 95% CI, 0.078-0.47; P <.001), complement C4 less than or equal to 0.095 g/L (HR, 3.642; 95% CI, 1.486-8.924; P =.005), and platelets less than or equal to 115.5×109/L (HR, 5.821; 95% CI, 2.522-13.436; P <.001).

This study was limited by its small sample size and retrospective design. Additional larger prospective studies are needed to confirm these findings.

These data indicated that serum complement C4 may be an independent predictor of overall survival in patients with newly diagnosed MM.


Zhang L, Ling X, Li F, et al. Complement 4 aids in the prediction of newly diagnosed multiple myeloma outcome in patients. Clin Med Insights Oncol. Published online February 28, 2022. doi:10.1177/11795549221079171

This article originally appeared on Oncology Nurse Advisor