免疫球蛋白D型多发性骨髓瘤：疾病概况、治疗反应及生存情况

Immunoglobulin D Multiple Myeloma: Disease Profile, Therapeutic Response, and Survival.

作者信息

Wang Guo-Rong, Sun Wan-Jun, Chen Wen-Ming, Huang Zhong-Xia, Zhang Jia-Jia, An Na, Shen Man, Li Xin

机构信息

Department of Hematology and Oncology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

出版信息

Acta Haematol. 2016;136(3):140-6. doi: 10.1159/000446599. Epub 2016 Jul 14.

DOI:10.1159/000446599

PMID:27409804

Abstract

OBJECTIVES

The long-term clinical characteristics, response to therapy, and survival in patients with immunoglobulin D (IgD) multiple myeloma (MM) were investigated.

METHODS

A retrospective study was conducted that included 68 patients treated in the last 10 years, 37 of whom received bortezomib only (bortezomib group), 13 of whom received bortezomib and underwent autologous hematopoietic stem cell transplantation (bortezomib + ASCT group), and 18 of whom received conditional chemotherapy (non-bortezomib group).

RESULTS

The ratio of males to females was 44:24, and the median age was 56.5 years. The overall response rate of each group was 91.9, 77.8, and 100%, respectively. The median overall survival (OS) and progression-free survival (PFS) were 24 and 15.5 months, respectively, among the 68 patients. The median OS of each group was 23, 21.5, and 27 months, respectively. The median PFS of each group was 18, 12, and 24 months, respectively. The 3- and 5-year OS were 64 and 45%, respectively, and the 3- and 5-year PFS were 39 and 13%, respectively, among the 68 patients. Cox regression showed that the percentage of bone marrow plasmacytosis was significantly associated with OS (p = 0.038).

CONCLUSIONS

The survival of IgD patients is shorter than that of other MM patients. Treatment strategies with bortezomib followed by stem cell transplantation may boost the response rate and improve survival.

摘要

目的

研究免疫球蛋白D（IgD）型多发性骨髓瘤（MM）患者的长期临床特征、治疗反应及生存情况。

方法

进行一项回顾性研究，纳入过去10年中治疗的68例患者，其中37例仅接受硼替佐米治疗（硼替佐米组），13例接受硼替佐米并进行自体造血干细胞移植（硼替佐米+自体造血干细胞移植组），18例接受传统化疗（非硼替佐米组）。

结果

男女比例为44:24，中位年龄为56.5岁。各组的总缓解率分别为91.9%、77.8%和100%。68例患者的中位总生存期（OS）和无进展生存期（PFS）分别为24个月和15.5个月。各组的中位OS分别为23个月、21.5个月和27个月。各组的中位PFS分别为18个月、12个月和24个月。68例患者的3年和5年OS分别为64%和45%，3年和5年PFS分别为39%和13%。Cox回归显示骨髓浆细胞增多百分比与OS显著相关（p = 0.038）。