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Objective: To explore potential predictors of RMPP in early stage.Study design: The prospective study, multicenter study was conducted in Zhejiang, China from May 1st, 2019 to January 31st, 2020. Children aged 29 days to 14 years old, with fever time during 48 to 120 hours were included. A total of 1428 children completed the study. A questionnaire was designed to collect patients’ information. Pharyngeal swab samples were collected. M. pneumoniae DNA in pharyngeal swab specimens were detected. Whether the patients develop to RMPP were assessed. Logistic regression analyses were used to examine associations between clinical data and RMPP.Results: The ages of the patients ranged from 34 days to 13.9 years with a median 4.3 years. The positive rate of M. pneumoniae -DNA was 37.4% (534/1428), and 446 cases were Mycoplasma pneumoniae pneumonia (MPP). In MPP patients, 55 cases were RMPP (12.3%), others were general MPP (GMPP) patients (n=391, 87.7%). Only the peak body temperature before the first visit and LDH level in RMPP patients were higher than that in GMPP [39.6 (39.1-40.0) °C vs. 39.2 (38.9-39.7) °C, p=0.003, and 332.5 (278.8-392.1) U/L vs. 310.5 (259.0-358.8) U/L, p=0.024]. Logistic regression also only included the above two parameters in the prediction probability. The area under ROC curve of the prediction probability π of RMPP was 0.682 (95% CI, 0.593-0.771), PConclusions: AND RELEVANCE A prediction probability, calculating from the peak body temperature before the first visit and LDH level for early identifying RMPP from other MPP within 2-5 days of fever duration, with a cut-off value of 0.12 may be helpful in clinical practice.

Multiple myeloma is genetically heterogeneous with varied clinical outcomes, primarily due to the coexistence of diverse numerical and structural cytogenetic abnormalities. The prognostic impact of hyperdiploidy in myeloma patients with high-risk cytogenetics remains controversial in Western studies and is unknown in China. We examined the cytogenetic features of hyperdiploidy in 201 Chinese patients with newly diagnosed myeloma using magnetic-activated cell sorting and interphase fluorescence in situ hybridization and analyzed the effect of hyperdiploidy on the prognosis of patients with high-risk cytogenetics. Hyperdiploidy was detected in 50.7% (102/201) of the examined patients, and the incidence of hyperdiploidy coexisting with high-risk cytogenetics [del(17p13), +1q21 and adverse t(14q32)] was 33.8% (68/201). Survival analysis showed that the median progression-free survival (PFS) and 2-year overall survival (OS) of patients were better for hyperdiploidy than those for non-hyperdiploidy (43 vs. 20 months, P = 0.01; 86.8% vs. 70.5%, P = 0.04) and for standard-risk cytogenetics than those for high-risk cytogenetics (not reached vs. 23 months, P = 0.0001; 87.6% vs. 74.4%, P = 0.01). Strikingly, the high-risk cytogenetics patients with hyperdiploidy showed a better median PFS than those without hyperdiploidy (34 vs. 15 months, P = 0.01); however, compared to standard-risk cytogenetics patients, the median PFS and 2-year OS were poorer (34 months vs. not reached, P = 0.02; 78.8% vs. 87.6%, P = 0.05). The independent predictors of PFS were non-hyperdiploidy, high-risk cytogenetics, and bone marrow plasma cells ≥ 30%, with hazard ratios of 2.01 (95% CI 1.25–3.25), 2.56 (95% CI 1.38–4.74), and 1.81 (95% CI 1.08–3.05), respectively, and those for OS were non-hyperdiploidy and serum lactate dehydrogenase ≥ 250 U/L, with hazard ratios of 2.53 (95% CI 1.24–5.46) and 3.53 (95% CI 1.50–6.96), respectively. These results suggest that the coexistence of hyperdiploidy may ameliorate the adverse prognosis of multiple myeloma patients with high-risk cytogenetics. High-risk cytogenetics patients without hyperdiploidy showed the worst prognosis.

Additional file 1: Table S1. Univariate analysis for PFS and OS of 216 patients with multiple myeloma.

The aim of our study was to evaluate the prognostic impact of minimal residual disease (MRD) and high-risk cytogenetics (HRCs) on outcomes in multiple myeloma (MM) patients. We applied multiparameter flow cytometry (MFC) to detect MRD in 123 consecutive patients diagnosed with MM for the first time who achieved very good partial remission (VGPR) or better after bortezomib or thalidomide-based induction therapy. Moreover, we examined the cytogenetic features of MM patients using magnetic-activated cell sorting and interphase fluorescence in situ hybridization (MACS-iFISH) at diagnosis. In all 123 MM patients, progression-free survival (PFS) and overall survival (OS) were better in the MRD− group (n = 31) than in the MRD+ group (n = 92) (median PFS: not reached (NR) vs. 26 months (m), P = 0.0002; 4-year OS, 91.7% vs. 66.3%, P = 0.008). PFS and OS were significantly shorter for each increase of one log per MRD level (P