Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
Am J Hematol. 2016 Jun;91(6):585-9. doi: 10.1002/ajh.24356. Epub 2016 Apr 13.
Over the past decade, a number of changes have occurred in the diagnostic evaluation, management, and long-term follow-up of patients with POEMS syndrome at our institution. This study included 291 patients with POEMS syndrome diagnosed at the Mayo Clinic between 1974 and 2014. Patients diagnosed after 2003 had more features of the syndrome identified at diagnosis and were more likely to receive an autologous transplant (49% versus 8%, P < 0.0001) and to have achieved a hematologic complete response (CR) to treatment (41% vs 25%, P < 0.0001). With 2273 person-years of follow-up, 10-year overall survival (OS) was 62% (95% C.I., 56%, 67%). On multivariate analysis, the three factors associated with superior OS were younger age (RR 0.98 [0.96-1.00]), albumin greater-than 3.2 g/dL (RR 0.5 [0.32-0.89]) and attainment of complete hematologic response (RR 0.4 [0.2, 0.9]). This study confirms the very good long-term outcomes of patients with POEMS syndrome and identifies two new prognostic risk factors: albumin at diagnosis and attainment of complete hematologic response. Am. J. Hematol. 91:585-589, 2016. © 2016 Wiley Periodicals, Inc.
在过去的十年中,我们机构在 POEMS 综合征患者的诊断评估、管理和长期随访方面发生了许多变化。本研究纳入了 1974 年至 2014 年间在 Mayo 诊所诊断为 POEMS 综合征的 291 例患者。2003 年后诊断的患者在诊断时更有可能出现更多的综合征特征,并且更有可能接受自体移植(49%对 8%,P<0.0001),并且对治疗有血液学完全缓解(CR)(41%对 25%,P<0.0001)。随访 2273 人年,10 年总生存率(OS)为 62%(95%CI,56%,67%)。多因素分析显示,与 OS 相关的三个因素是年龄较小(RR 0.98[0.96-1.00])、白蛋白大于 3.2 g/dL(RR 0.5[0.32-0.89])和完全血液学缓解(RR 0.4[0.2,0.9])。本研究证实了 POEMS 综合征患者的长期预后非常好,并确定了两个新的预后危险因素:诊断时的白蛋白和完全血液学缓解的获得。Am. J. Hematol. 91:585-589, 2016. © 2016 Wiley Periodicals, Inc.