Kaneko M, Kanda Y, Oshima K, Nannya Y, Suguro M, Yamamoto R, Chizuka A, Hamaki T, Matsuyama T, Takezako N, Miwa A, Togawa A
Department of Hematology, International Medical Center of Japan, Japan.
Ann Hematol. 2002 Jan;81(1):33-6. doi: 10.1007/s00277-001-0388-5. Epub 2001 Nov 10.
The range of survival duration in myeloma patients is wide and several percent of patients live longer than 10 years. Therefore, a precise prediction of survival for the individual patient is required to decide treatment. We evaluated possible prognostic factors at diagnosis for 116 Japanese patients with multiple myeloma. Twelve parameters reported to affect survival were analyzed using a log rank test and stepwise Cox proportional hazards regression. Factors identified as adversely affecting survival were age over 60 years, male sex, blood hemoglobin less than 8.5 g/dl, platelets less than 100 x 10(9)/l, serum creatinine level more than 2.0 mg/dl, serum C-reactive protein (CRP) level more than 6.0 mg/l, and serum beta2-microglobulin level more than 6.0 mg/l. Among them, only high age and high serum CRP level were independently prognostic for poor survival. In conclusion, we have established a simple prognostic model for Japanese myeloma patients only, using factors that can be determined in routine examinations without the need of subjective information.
骨髓瘤患者的生存持续时间范围很广，有百分之几的患者存活时间超过10年。因此，为了决定治疗方案，需要对个体患者的生存情况进行精确预测。我们评估了116例日本多发性骨髓瘤患者诊断时可能的预后因素。使用对数秩检验和逐步Cox比例风险回归分析了12个据报道会影响生存的参数。被确定为对生存有不利影响的因素包括年龄超过60岁、男性、血红蛋白低于8.5 g/dl、血小板低于100×10⁹/l、血清肌酐水平高于2.0 mg/dl、血清C反应蛋白（CRP）水平高于6.0 mg/l以及血清β2-微球蛋白水平高于6.0 mg/l。其中，只有高龄和高血清CRP水平是生存不良的独立预后因素。总之，我们仅利用在常规检查中可确定的因素，无需主观信息，为日本骨髓瘤患者建立了一个简单的预后模型。
