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[223例新诊断多发性骨髓瘤患者的临床特征、化疗反应及生存情况]

[The clinical features, chemotherapy responses and survival of 223 patients with newly diagnosed multiple myeloma].

作者信息

Li Juan, Zhao Ying, Luo Shao-Kai, Huang Bei-Hui, Zhang Guo-Cai, Peng Ai-Hua, Zheng Dong, Su Chang, Xu Duo-Rong, Tong Xiu-Zhen, Gu Jing-Li, Ding Yan

机构信息

Department of Hematology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Aug 5;88(30):2140-3.

Abstract

OBJECTIVE

To explore the proportion, clinical and laboratory features, chemotherapy responses and long term survival of different kinds of newly diagnosed multiple myeloma (MM) in China.

METHODS

The clinical data of 223 cases of newly diagnosed MM patients were gathered in the First Affiliated Hospital of Sun Yat-sen University from Jan, 2000 to Seb, 2007 were retrospectively analyzed.

RESULTS

The proportions of each kind of MM including IgG, IgA, light chain, IgD, IgM and biclonal MM were 48.0%, 20.6%, 25.6%, 4.0%, 0.9% and 0.9% respectively. No IgE and nonsecretory myeloma was found. The median age of onset was 58 years, of which that of the IgA type was the oldest one and the light chain type was the youngest (P = 0.004). Bone pain, renal insufficiency, and anemia were the most common symptoms which accounted for 67.7%, 61.0% and 45.3% respectively. The incidences of renal inadequacy, hypercalcemia and pathological fracture in light chain type were higher than those in IgG and IgA types. Besides, no M protein were found in serum protein electrophoresis and no elevation of total globulin. The clinical features of IgD type were similar to that of the light-chain type. The total chemotherapy efficacy rate of 89 patients who were treated with more than 3 cycles in our hospital is 61.8%, which has no difference in all types. Median overall survival of the 89 patients was 33.0 months.

CONCLUSION

IgG is the most common type in MM. Bone pain, anemia, hypercalcemia and renal insufficiency are common symptoms. Immunofixation electrophoresis should be performed routinely to avoid missed diagnosis of light-chain and IgD types of MM.

摘要

目的

探讨中国新诊断的不同类型多发性骨髓瘤(MM)的比例、临床及实验室特征、化疗反应和长期生存情况。

方法

回顾性分析2000年1月至2007年9月在中山大学附属第一医院收治的223例新诊断MM患者的临床资料。

结果

各类型MM包括IgG型、IgA型、轻链型、IgD型、IgM型和双克隆MM的比例分别为48.0%、20.6%、25.6%、4.0%、0.9%和0.9%。未发现IgE型和非分泌型骨髓瘤。发病年龄中位数为58岁,其中IgA型患者年龄最大,轻链型患者年龄最小(P = 0.004)。骨痛、肾功能不全和贫血是最常见的症状,分别占67.7%、61.0%和45.3%。轻链型患者肾功能不全、高钙血症和病理性骨折的发生率高于IgG型和IgA型患者。此外,血清蛋白电泳未发现M蛋白,总球蛋白未升高。IgD型的临床特征与轻链型相似。我院接受3个以上周期治疗的89例患者的总化疗有效率为61.8%,各类型之间无差异。这89例患者的中位总生存期为33.0个月。

结论

IgG型是MM最常见的类型。骨痛、贫血、高钙血症和肾功能不全是常见症状。应常规进行免疫固定电泳以避免漏诊轻链型和IgD型MM。

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