年轻及老年华氏巨球蛋白血症患者的预后评估：国际预后评分系统及血清乳酸脱氢酶的重要性

Prognostication in young and old patients with Waldenström's macroglobulinemia: importance of the International Prognostic Scoring System and of serum lactate dehydrogenase.

作者信息

Kastritis Efstathios, Zervas Konstantinos, Repoussis Panagiotis, Michali Evridiki, Katodrytou Eirini, Zomas Athanasios, Simeonidis Argiris, Terpos Evangelos, Delimbassi Sossana, Vassou Amalia, Gika Dimitra, Dimopoulos Meletios A

机构信息

Department of Clinical Therapeutics, University of Athens, School of Medicine, Greece.

出版信息

Clin Lymphoma Myeloma. 2009 Mar;9(1):50-2. doi: 10.3816/CLM.2009.n.012.

DOI:10.3816/CLM.2009.n.012

PMID:19362972

Abstract

We analyzed 232 patients with previously untreated, symptomatic WM, of whom 10% were < or = 50 years of age and 21% were > 75 years of age. Disease features and response to treatment were similar among age groups. Patients > 75 years of age had significantly shorter survival (OS; 53 months vs. 113 months for those > 50-75 years vs. not reached for patients < or = 50 years of age; P < .001). Despite the fact that 33% of elderly patients died of causes unrelated to WM, disease-specific survival (DSS) was 72 months for patients > 75 years, 120 months for those > 50-75 years and not reached for patients < or = 50 years (P = .001). International Prognostic Scoring System for WM (IPSSWM) could discriminate 3 risk groups with significantly different OS or DSS. The addition of elevated serum lactate dehydrogenase in the IPSS improved the ability of IPSS to identify a group of patients with a significantly worse outcome (median survival, 55 months).

摘要

我们分析了232例先前未经治疗的有症状的华氏巨球蛋白血症（WM）患者，其中10%年龄小于或等于50岁，21%年龄大于75岁。各年龄组的疾病特征和治疗反应相似。年龄大于75岁的患者生存期显著缩短（总生存期[OS]；大于50至75岁的患者为53个月，小于或等于50岁的患者未达到，大于75岁的患者为113个月；P<0.001）。尽管33%的老年患者死于与WM无关的原因，但年龄大于75岁患者的疾病特异性生存期（DSS）为72个月，大于50至75岁的患者为120个月，小于或等于50岁的患者未达到（P = 0.001）。WM国际预后评分系统（IPSSWM）可区分出3个风险组，其OS或DSS有显著差异。IPSS中加入血清乳酸脱氢酶升高可提高IPSS识别一组预后明显较差患者的能力（中位生存期，55个月）。