Eleutherakis-Papaiakovou V, Bamias A, Gika D, Simeonidis A, Pouli A, Anagnostopoulos A, Michali E, Economopoulos T, Zervas K, Dimopoulos M A
Department of Clinical Therapeutics, University of Athens, School of Medicine, Greece.
Leuk Lymphoma. 2007 Feb;48(2):337-41. doi: 10.1080/10428190601126602.
Renal failure (RF) is a common and severe complication of patients with multiple myeloma (MM). The purpose of our study was to assess the incidence of RF in a contemporary series of newly diagnosed patients with MM, its association with specific clinical and laboratory features, and its impact on patients' outcome. Over the last decade, 756 newly diagnosed symptomatic patients with MM were included in our database. Renal failure, defined as a serum creatinine >or= 2 mg/dl at the time of diagnosis, was seen in 21% of patients. Multiple parameters were associated with RF, but logistic regression analysis showed that RF was independently associated only with International Staging System and Bence Jones proteinuria. The presence of RF was associated with a trend for higher early death rate but with a similar response to primary therapy. The median survival of patients with RF was 19.5 months versus 40.4 months for patients without RF (p < 0.001). Several variables were associated with impaired survival by univariate analysis. When multivariate analysis was performed the independent variables were poor performance status, thrombocytopenia, advanced age, high LDH and elevated serum beta2 microglobulin but not high creatinine. When corrected for stage, renal failure had no impact on survival.
肾衰竭（RF）是多发性骨髓瘤（MM）患者常见且严重的并发症。我们研究的目的是评估当代一系列新诊断的MM患者中RF的发生率、其与特定临床和实验室特征的关联以及对患者预后的影响。在过去十年中，我们的数据库纳入了756例新诊断的有症状MM患者。诊断时血清肌酐≥2mg/dl定义为肾衰竭，21%的患者出现肾衰竭。多个参数与RF相关，但逻辑回归分析显示，RF仅与国际分期系统和本周氏蛋白尿独立相关。RF的存在与较高的早期死亡率趋势相关，但对初始治疗的反应相似。有RF患者的中位生存期为19.5个月，无RF患者为40.4个月（p<0.001）。单因素分析显示，几个变量与生存受损相关。进行多因素分析时，独立变量为体能状态差、血小板减少、高龄、高乳酸脱氢酶和血清β2微球蛋白升高，但不包括高肌酐。校正分期后，肾衰竭对生存无影响。
