Abstract: Abstract: Objective To analyze the clinical characteristics and prognosis of newly diagnosed multiple myeloma (MM)
patients with different types of extramedullary disease (EMD). Methods Data of gender, age, immunoglobulin type, DS
stage, ISS stage and other clinical characteristics of 99 MM patients with EMD who were admitted to our hospital and had
complete clinical data were retrospectively analyzed. The survival analysis and prognostic analysis on patients with different
types of extramedullary diseases were performed, and the prognostic significance of different therapeutic regimens was
explored. Results There were no significant differences in clinical characteristics between MM patients with the bonerelated EMD (bEMD, n=57) and strict EMD (sEMD, n=42, P＞0.05). The two types of extramedullary diseases were mainly
found in ribs (42.1%) and soft tissues (50.0%) respectively. There were significant differences in median OS time (45 months
vs. 15 months, P＜0.05) and median PFS (20 months vs. 10 months, P＜0.05) between bEMD group and sEMD group. It was
found that age≥60 years (HR=2.333, 95%CI:1.025-5.309, P＜0.05),β2-MG≥2.7 mg/L (HR=4.361, 95%CI:1.304-14.587,
P＜0.05) and mutation of TP53 (HR=3.697, 95%CI:1.015-13.469,P＜0.05) were independent prognostic factors affecting
OS in EMD patients. The median PFS (49 months vs. 9 months, P＜0.05) and median OS (79 months vs. 12 months, P＜0.05)
of patients with sequential ASCT after bortezomi-induced chemotherapy in the sEMD group were statistically significant
compared with those without ASCT. Conclusion The prognosis of MM patients with sEMD is worse than that of bEMD
patients. The sequential autologous hematopoietic stem cell transplantation with bortezomib chemotherapy may prolong the survival and improve prognosis of patients with sEMD.

Key words: multiple myeloma, boronic acids, hematopoietic stem cell transplantation, prognosis, extramedullary
disease, bortezomib