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多发性骨髓瘤与不同肿瘤的关联:骨髓瘤连续患者的系统分析。

Association of multiple myeloma with different neoplasms: systematic analysis in consecutive patients with myeloma.

机构信息

Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany.

出版信息

Leuk Lymphoma. 2011 Feb;52(2):247-59. doi: 10.3109/10428194.2010.529207. Epub 2010 Nov 5.

Abstract

Multiple myeloma (MM) has been suggested to be associated with different neoplasms. Of 589 consecutive patients with MM, 59 (10%) had different neoplasms: solid tumors in 78% and hematological neoplasms in 22%. Different neoplasms were separated into those emerging prior or synchronously (p/s; n = 41) versus subsequently after the MM (n = 18). The rate of different neoplasms at the time of MM diagnosis was estimated as 6.6%, and estimated different neoplasm rates at 2, 5, and 10 years were 7.8%, 10.3%, and 11.6%, respectively. Patients with MM with p/s different neoplasms showed a hazard ratio (HR) for impaired overall survival of 1.2 (95% CI 0.8-2.0), whereas in those with subsequent neoplasms the HR was 2.5 (95% CI 1.4-4.4). This demonstrates that (1) p/s are more frequent compared with subsequent different neoplasms, and (2) the prognosis is more impaired with subsequent different neoplasms. Age ≥60 years was a confounding covariable with a HR of 2.021 (95% CI 1.6-2.6).

摘要

多发性骨髓瘤(MM)与不同的肿瘤有关。在 589 例连续 MM 患者中,有 59 例(10%)患有不同的肿瘤:实体瘤占 78%,血液系统肿瘤占 22%。不同的肿瘤分为先发性或同时性(p/s;n=41)与 MM 后性(n=18)。MM 诊断时不同肿瘤的发生率估计为 6.6%,2、5 和 10 年的不同肿瘤发生率估计分别为 7.8%、10.3%和 11.6%。p/s 不同肿瘤的 MM 患者的总生存率 HR 为 1.2(95%CI 0.8-2.0),而随后发生肿瘤的 HR 为 2.5(95%CI 1.4-4.4)。这表明:(1)p/s 比随后发生的不同肿瘤更为常见;(2)随后发生的不同肿瘤预后更差。年龄≥60 岁是一个混杂的协变量,HR 为 2.021(95%CI 1.6-2.6)。

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