* Department of Medical Hematology/Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan.
Jpn J Clin Oncol. 2014 May;44(5):435-41. doi: 10.1093/jjco/hyu017. Epub 2014 Mar 23.
Tumor-lysis syndrome is a rare complication in patients with multiple myeloma. However, bortezomib treatment for myeloma is often associated with tumor-lysis syndrome.
We developed an index called the rapid anemia progression index, which represents the duration and progression of anemia, to evaluate risk factors for tumor-lysis syndrome. We retrospectively reviewed 35 relapsed or refractory myeloma patients treated with bortezomib-containing treatment in our institution. We analyzed various parameters, including albumin, lactase dehydrogenase, β2-microglobulin and creatinine, similar to the rapid anemia progression index, and evaluated the risk factors for tumor-lysis syndrome associated with bortezomib by the Cairo-Bishop definition.
Clinical tumor-lysis syndrome occurred in six patients (17.1%). Tumor-lysis syndrome occurred during the first course of bortezomib-containing treatment among all the patients. The result of the area under the receiver operating characteristic curve for the rapid anemia progression index was 0.759 (P = 0.049). The rapid anemia progression index was more accurate than the index of lactate dehydrogenase, β2-microglobulin, albumin and creatinine according to the receiver operating characteristic curve. For a cut-off point of -1.12 for the rapid anemia progression index, the sensitivity and specificity were 66.7 and 82.8%, respectively.
The rapid anemia progression index is related to clinical tumor-lysis syndrome associated with bortezomib treatment for multiple myeloma patients with a cut-off point of -1.12 g/dl/month.
肿瘤溶解综合征是多发性骨髓瘤患者的一种罕见并发症。然而，硼替佐米治疗多发性骨髓瘤常与肿瘤溶解综合征相关。
我们开发了一个称为快速贫血进展指数的指标，该指标代表贫血的持续时间和进展程度，以评估肿瘤溶解综合征的危险因素。我们回顾性分析了在我院接受硼替佐米治疗的 35 例复发或难治性骨髓瘤患者的各种参数，包括白蛋白、乳酸脱氢酶、β2-微球蛋白和肌酐，类似于快速贫血进展指数，并根据开罗-毕晓普定义评估与硼替佐米相关的肿瘤溶解综合征的危险因素。
6 例患者（17.1%）出现临床肿瘤溶解综合征。所有患者均在接受硼替佐米治疗的第一个疗程中出现肿瘤溶解综合征。快速贫血进展指数的受试者工作特征曲线下面积为 0.759（P=0.049）。根据受试者工作特征曲线，快速贫血进展指数比乳酸脱氢酶、β2-微球蛋白、白蛋白和肌酐指数更准确。对于快速贫血进展指数的截断值为-1.12 g/dl/月，其灵敏度和特异性分别为 66.7%和 82.8%。
快速贫血进展指数与硼替佐米治疗多发性骨髓瘤患者的临床肿瘤溶解综合征相关，截断值为-1.12 g/dl/月。
