Zhu Wanqiu, Lu Jing, Lu Jin, Hou Jian, Huang Xiaojun, Chen Wenming
Beijing Chao-Yang Hospital, Capital Medical University; Department of Hematology and Multiple Myeloma Research Center of Beijing, Beijing 100020, China.
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Zhonghua Yi Xue Za Zhi. 2015 Mar 17;95(10):741-4.
To explore the clinical features and prognostic factors of newly diagnosed multiple myeloma patients with renal insufficiency (MM-RI).
The clinical features, survival rates and prognostic factors were retrospectively analyzed for 897 newly diagnosed multiple myeloma (MM) patients at three hospital from January 1, 2010 to June 30, 2012.
Among them, there were 177 cases (19.7%) of MM-RI patients. There were 125 males and 52 females with an average age of 59 years. And 28.2% (50/177) were over 65 years. The types were 17.2% (30/174) of immunoglobulin (Ig)D-λ and 27.6% (48/174) of light chain isotype. And the stages were 94.9% of DS stage III (167/176) and ISS stage III (166/175). Compared with MM patients with normal renal function (MM-RN), MM-RI group had a higher proportion of patients with IgD-λ and light chain isotype, more patients of DS and ISS stage III; elevated bone marrow plasma cells, white blood cells and uric acid; lower hemoglobin and platelet (all P < 0.05). After a median follow-up period of 24 (2-114) months, the median progression-free survival (PFS) was 28.0 months for MM-RI patients and 29.0 months for MM-RN patients. And the difference was not statistically significant (P = 0.457). The estimated median overall survival (OS) was 44.0 months for MM-RI patients and 59.2 months for MM-RN patients. And the difference was statistically significant (P = 0.033). Log-rank univariate analysis showed that age, LDH, β2-MG, first-line treatment with or without bortezomib and previous transplantation or not were independent prognostic factors of MM patients.
MM-RI and MM-RN patients have different clinical features. Age, LDH, β2-MG, first-line treatment with or without bortezomib and previous transplantation or not are independent prognostic factors for newly diagnosed MM patients.
探讨新诊断的合并肾功能不全的多发性骨髓瘤患者（MM-RI）的临床特征及预后因素。
回顾性分析2010年1月1日至2012年6月30日期间三家医院897例新诊断的多发性骨髓瘤（MM）患者的临床特征、生存率及预后因素。
其中，MM-RI患者177例（19.7%）。男性125例，女性52例，平均年龄59岁。65岁以上者占28.2%（50/177）。免疫球蛋白（Ig）D-λ型占17.2%（30/174），轻链型占27.6%（48/174）。分期方面，DS分期Ⅲ期占94.9%（167/176），ISS分期Ⅲ期占94.9%（166/175）。与肾功能正常的MM患者（MM-RN）相比，MM-RI组IgD-λ型和轻链型患者比例更高，DS和ISS分期Ⅲ期患者更多；骨髓浆细胞、白细胞及尿酸升高；血红蛋白及血小板降低（均P<0.05）。中位随访24（2-114）个月后，MM-RI患者的中位无进展生存期（PFS）为28.0个月，MM-RN患者为29.0个月。差异无统计学意义（P=0.457）。MM-RI患者的估计中位总生存期（OS）为44.0个月，MM-RN患者为59.2个月。差异有统计学意义（P=0.033）。Log-rank单因素分析显示，年龄、乳酸脱氢酶（LDH）、β2微球蛋白（β2-MG）、一线治疗是否使用硼替佐米及既往是否移植是MM患者的独立预后因素。
MM-RI与MM-RN患者具有不同的临床特征。年龄、LDH、β2-MG、一线治疗是否使用硼替佐米及既往是否移植是新诊断MM患者的独立预后因素。
