Hwa Yi L, Shi Qian, Kumar Shaji K, Lacy Martha Q, Gertz Morie A, Kapoor Prashant, Buadi Francis K, Leung Nelson, Dingli David, Go Ronald S, Hayman Suzanne R, Gonsalves Wilson I, Russell Stephen, Lust John A, Lin Yi, Rajkumar S Vincent, Dispenzieri Angela
Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.
Division of Biomedical Statistics and Informatics, Department of Health Science Research, Mayo Clinic, Rochester, MN.
Am J Hematol. 2017 Jan;92(1):50-55. doi: 10.1002/ajh.24582. Epub 2016 Nov 18.
A preclinical study demonstrated anti-proliferative and apoptotic effect of propranolol on multiple myeloma (MM) cell. Clinical studies suggested that beta-blocker (BB) might impact the prognosis of breast, prostate, colorectal, ovarian, lung, and skin cancer. This retrospective study evaluated the effect of BB in MM disease-specific survival (DSS) and overall survival (OS). Among 1,971 newly diagnosed MM patients seen at Mayo Clinic between 1995 and 2010, usage of BB and other cardiac (or antihypertensive) medications were abstracted. Cumulative incidence function and Kaplan-Meier method were used to estimate 5-year cumulative incidence rate (CIR) of MM death and OS rate, respectively. Nine hundred and thirty (47.2%) patients had no intake of cardiac medications; 260 (13.2%) used BB alone; 343 (17.4%) used both BB/non-BB cardiac medications; and 438 (22.2%) had non-BB cardiac drugs. Superior MM DSS was observed in BB only users, compared to patients without any cardiac drugs ( HRadj.CS, 0.53, 95% confidence interval [CI], 0.42-0.67, P <0.0001) and non-BB cardiac drugs users ( HRadj.CS, 0.49, 95% CI, 0.38-0.63, P <0.0001). Patients on both BB and other cardiac drugs showed superior DSS than non-cardiac drugs users ( HRadj.CS, 0.54, 95% CI, 0.44-0.67, P <0.0001) and non-BB cardiac drug users. ( HRadj.CS, 0.50, 95% CI, 0.40-0.62, P <0.0001). MM DSS did not differ between BB users with and without other cardiac drugs (P =0.90). Multivariable analysis showed the same pattern for OS. In patients with MM, BB intake is associated with a reduced risk of disease-specific death and overall mortality in comparison to non-BB or no use of cardiac drugs. Am. J. Hematol. 92:50-55, 2017. © 2016 Wiley Periodicals, Inc.
一项临床前研究证明了普萘洛尔对多发性骨髓瘤（MM）细胞具有抗增殖和凋亡作用。临床研究表明，β受体阻滞剂（BB）可能会影响乳腺癌、前列腺癌、结直肠癌、卵巢癌、肺癌和皮肤癌的预后。这项回顾性研究评估了BB对MM疾病特异性生存（DSS）和总生存（OS）的影响。在1995年至2010年间于梅奥诊所就诊的1971例新诊断MM患者中，提取了BB及其他心脏（或抗高血压）药物的使用情况。分别采用累积发病率函数和Kaplan-Meier方法来估计MM死亡的5年累积发病率（CIR）和OS率。930例（47.2%）患者未服用心脏药物；260例（13.2%）仅使用BB；343例（17.4%）同时使用BB/非BB心脏药物；438例（22.2%）使用非BB心脏药物。与未服用任何心脏药物的患者（校正后HR，0.53，95%置信区间[CI]，0.42 - 0.67，P <0.0001）和使用非BB心脏药物的患者相比，仅使用BB的患者观察到更好的MM DSS（校正后HR，0.49，95% CI，0.38 - 0.63，P <0.0001）。同时使用BB和其他心脏药物的患者比未使用心脏药物的患者（校正后HR，0.54，95% CI，0.44 - 0.67，P <0.0001）和使用非BB心脏药物的患者表现出更好的DSS（校正后HR，0.50，95% CI，0.40 - 0.62，P <0.0001）。使用BB且使用或未使用其他心脏药物的患者之间MM DSS无差异（P =0.90）。多变量分析显示OS也有相同模式。在MM患者中，与未使用BB或未使用心脏药物相比，服用BB与疾病特异性死亡风险和总死亡率降低相关。《美国血液学杂志》92:50 - 55，2017年 © 2016威利期刊公司
