造血干细胞移植后多发性骨髓瘤患者的异常蛋白带：是否具有预后意义？
Abnormal protein bands in patients with multiple myeloma after haematopoietic stem cell transplantation: does it have a prognostic significance?
机构信息
Department of Hematology, Faculty of Medicine, Gazi University, Ankara, Turkey.
出版信息
Hematol Oncol. 2010 Dec;28(4):180-4. doi: 10.1002/hon.936.
Abnormal protein bands (APB) unrelated to the original monoclonal protein occasionally appear in serum immunofixation samples from patients with multiple myeloma (MM) following haematopoietic stem cell transplantation (HCT). To investigate the significance of APB, medical records and serum immunofixation patterns of 53 MM patients, who had undergone HCT (49 autologous and 4 allogeneic) at the stem cell transplantation unit of Gazi University Faculty of Medicine, were reviewed. Patients were staged according to Durie-Salmon and International staging systems (ISS) and disease response was determined according to European Bone Marrow Transplantation (EBMT) criteria. Fourteen (26.4%) of the 53 patients developed APBs after HCT. The median time for the appearance and duration of APB was 3 (range 1-24) and 5.5 (range 1.5-14) months, respectively. Probability of overall survival (OS) at the end of the follow-up was 77 and 61.4% in patients with and without APB, respectively (p = 0.334). The median duration of follow-up (767 days (range, 220-2905) vs. 726 days (range, 120-1780) p = 0.545) was not different in patients with and without APB. Probability of progression free survival (PFS) at the end of follow-up was 28.8% in patients with and 27.7% in patients without APB (p = 0.835). PFS (910 days (range 180-2905) vs. 730 days (range 90-1765) p = 0.835) was longer in patients with APB, though without statistical significance. Thus, the occurrence of APB post-transplantation is not associated with any adverse long-term consequences and does not require treatment modification.
异常蛋白带（APB）与多发性骨髓瘤（MM）患者造血干细胞移植（HCT）后的原始单克隆蛋白无关，偶尔会出现在血清免疫固定样本中。为了研究 APB 的意义，我们回顾了在加济大学医学院干细胞移植科接受 HCT（49 例自体和 4 例异体）的 53 例 MM 患者的病历和血清免疫固定模式。患者根据 Durie-Salmon 和国际分期系统（ISS）分期，根据欧洲骨髓移植（EBMT）标准确定疾病反应。53 例患者中有 14 例（26.4%）在 HCT 后出现 APB。APB 出现和持续的中位时间分别为 3（范围 1-24）和 5.5（范围 1.5-14）个月。在随访结束时，APB 患者的总生存率（OS）为 77%，无 APB 患者为 61.4%（p=0.334）。APB 患者和无 APB 患者的中位随访时间（767 天（范围 220-2905）与 726 天（范围 120-1780），p=0.545）无差异。随访结束时，APB 患者的无进展生存率（PFS）为 28.8%，无 APB 患者为 27.7%（p=0.835）。APB 患者的 PFS （910 天（范围 180-2905）与 730 天（范围 90-1765），p=0.835）较长，但无统计学意义。因此，移植后 APB 的发生与任何不良的长期后果无关，不需要治疗改变。
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