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中国 POEMS 综合征患者的临床特征和长期预后。

Clinical characteristics and long-term outcome of patients with POEMS syndrome in China.

机构信息

Department of Hematology, Peking Union Medical College Hospital, Beijing, 100730, China.

出版信息

Ann Hematol. 2011 Jul;90(7):819-26. doi: 10.1007/s00277-010-1149-0. Epub 2011 Jan 8.

Abstract

POEMS syndrome is a rare plasma cell dyscrasia characterized by polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes. This study reviewed the clinical characteristics and long-term outcome of 99 consecutive Chinese patients with newly diagnosed POEMS syndrome in a single institute. The median age of 99 patients was 45 years, and the ratio of men/women was 1.4. The median time from onset of symptoms to diagnosis was 18 months. The typical five features of peripheral neuropathy, organomegaly, endocrinopathy, M protein, and skin change remained to be essential for patients with POEMS syndrome in China. The unusual features like pulmonary hypertension (36%) and renal impairment (37%) were not uncommon in China. Eighty-three percent patients were alive after follow-up time of 25 months, and 10% patients had survived more than 60 months. Melphalan-based therapy (OR, 0.076; 95% CI, 0.02-0.285) and normal renal function (OR, 0.246; 95% CI, 0.076-0.802) were independent prognostic factors for the survival of patients with POEMS syndrome. In conclusion, POEMS syndrome in Chinese patients was a multi-systemic disease with clinical features similar to non-Chinese ones. Active therapy can effectively improve the prognosis of patients with POEMS syndrome.

摘要

POEMS 综合征是一种罕见的浆细胞异常疾病,其特征为多发性神经病、器官肿大、内分泌病、M 蛋白和皮肤改变。本研究回顾了单中心 99 例新诊断 POEMS 综合征患者的临床特征和长期预后。99 例患者的中位年龄为 45 岁,男女比例为 1.4。从症状出现到诊断的中位时间为 18 个月。中国 POEMS 综合征患者的典型五种特征(周围神经病、器官肿大、内分泌病、M 蛋白和皮肤改变)仍然是必要的。在中国,不常见的特征,如肺动脉高压(36%)和肾功能损害(37%)并不罕见。83%的患者在 25 个月的随访后仍存活,10%的患者存活时间超过 60 个月。基于马法兰的治疗(OR,0.076;95%CI,0.02-0.285)和正常肾功能(OR,0.246;95%CI,0.076-0.802)是 POEMS 综合征患者生存的独立预后因素。总之,中国患者的 POEMS 综合征是一种多系统疾病,其临床特征与非中国患者相似。积极治疗可有效改善 POEMS 综合征患者的预后。

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