多发性骨髓瘤中的全血细胞减少症——一个谜团：我们在三级医疗医院的经验

Pancytopenia in Multiple Myeloma- An Enigma: Our Experience from Tertiary Care Hospital.

作者信息

Sridevi Hanaganahalli B, Rai Sharada, Suresh Pooja K, Somesh Meludurgamutt S, Minal Jessica

机构信息

Assistant Professor, Department of Pathology, Kasturba Medical College , Mangalore, Manipal University, India .

Associate Professor, Department of Pathology, Kasturba Medical College , Mangalore, Manipal University, India .

出版信息

J Clin Diagn Res. 2015 Nov;9(11):EC04-6. doi: 10.7860/JCDR/2015/12788.6718. Epub 2015 Nov 1.

DOI:10.7860/JCDR/2015/12788.6718

PMID:26673280

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4668413/

Abstract

INTRODUCTION

Multiple myeloma is a plasma cell neoplasm that is characterized by clonal proliferation of malignant plasma cell in the bone marrow along with M-protein in the serum and/or urine. Pancytopenia as a initial presentation of multiple myeloma is quite unusual. We are presenting a case series having pancytopenia as the presenting complaint.

MATERIALS AND METHODS

A retrospective study was conducted for a period of 30 months, wherein all the cases of multiple myeloma presenting with pancytopenia were included. The complete blood picture, peripheral smear examination, bone marrow aspirate & protein electrophoresis of all the cases were reviewed & analysed.

RESULTS

During the study period, 10 cases presented with pancytopenia with a mean age of 66.3 years (range: 59-72 years) at presentation with male: female ratio being 8:2. Fatigue and weakness was the most common symptom (100%) & average ESR was 104 mm/hour. High-resolution serum electrophoresis, showed a dense, sharp to wide M band in the gamma globulin region. Bone marrow plasma cell percentage was increased with an average of 63.1%. Bone marrow biopsy correlation was obtained in 100% cases.

CONCLUSION

Diagnosing multiple myeloma, presenting as pancytopenia requires a high degree of suspicion to avoid delay in initiation of treatment.

摘要

引言

多发性骨髓瘤是一种浆细胞肿瘤，其特征是骨髓中恶性浆细胞的克隆性增殖以及血清和/或尿液中的M蛋白。全血细胞减少作为多发性骨髓瘤的初始表现非常罕见。我们现报告一组以全血细胞减少为主要诉求的病例系列。

材料与方法

进行了一项为期30个月的回顾性研究，纳入所有以全血细胞减少为表现的多发性骨髓瘤病例。对所有病例的全血细胞计数、外周血涂片检查、骨髓穿刺及蛋白电泳进行回顾和分析。

结果

在研究期间，10例患者表现为全血细胞减少，初诊时平均年龄为66.3岁（范围：59 - 72岁），男女比例为8:2。疲劳和虚弱是最常见的症状（100%），平均血沉率为104毫米/小时。高分辨率血清电泳显示γ球蛋白区域有一条致密、尖锐至宽阔的M带。骨髓浆细胞百分比升高，平均为63.1%。100%的病例获得了骨髓活检相关性。