Pertuiset E, Chevret S, Lioté F, Delauche M C, Bardin T, Dryll A, Kuntz D
Clinique de Rhumatologie, Centre Viggo Petersen, Hôpital Lariboisière, Paris.
Ann Med Interne (Paris). 1992;143(8):519-24.
In this retrospective study, survival and prognostic factors were analysed in 65 patients with stage II-III multiple myeloma with osteolytic lesions. Multiple myeloma was diagnosed from 1976 to 1984, and patients were treated with conventional chemotherapy. The response rate to initial chemotherapy was 46%. The median survival time was 31 months. The 10-year survival rate was 10%. Four variables were individually prognostic: response to initial chemotherapy, bone marrow plasma cell percentage, the Durie and Salmon staging system, a biological staging system derived from Durie and Salmon's biological criteria regardless of bone lesions. In the multivariate analysis, only two prognostic variables were retained, namely the response to chemotherapy and the biological staging system. No prognostic value was observed for the extent of osteolytic lesions. This study suggests that, in conventionally treated multiple myeloma, long-term survival has improved compared with the previous decade. It also indicates that the extent of osteolytic lesions has little value for the definition of high-risk myeloma.
在这项回顾性研究中，对65例伴有溶骨性病变的II - III期多发性骨髓瘤患者的生存情况和预后因素进行了分析。多发性骨髓瘤的诊断时间为1976年至1984年，患者接受了传统化疗。初始化疗的缓解率为46%。中位生存时间为31个月。10年生存率为10%。有四个变量分别具有预后意义：对初始化疗的反应、骨髓浆细胞百分比、Durie和Salmon分期系统，以及一种源自Durie和Salmon生物学标准且不考虑骨病变的生物学分期系统。在多变量分析中，仅保留了两个预后变量，即化疗反应和生物学分期系统。未观察到溶骨性病变范围的预后价值。这项研究表明，在接受传统治疗的多发性骨髓瘤中，与前十年相比，长期生存率有所提高。它还表明，溶骨性病变范围对高危骨髓瘤的定义价值不大。
