Nakaya Aya, Fujita Shinya, Satake Atsushi, Nakanishi Takahisa, Azuma Yoshiko, Tsubokura Yukie, Hotta Masaaki, Yoshimura Hideaki, Ishii Kazuyoshi, Ito Tomoki, Nomura Shosaku
First Department of Internal Medicine, Kansai Medical University , Hirakata, Japan.
Hematol Rep. 2017 Feb 23;9(1):6887. doi: 10.4081/hr.2017.6887.
The acronym summarizes the most typical clinical manifestations of multiple myeloma, these being hypercalcemia, renal failure, anemia, and bone disease. CRAB can be used to distinguish between active, symptomatic multiple myeloma and monoclonal gammopathy of undermined significance or smoldering myeloma. The distinction is relevant not only for classification and diagnosis but also for therapy. CRAB factors influence the prognosis of multiple myeloma. However, it is unclear whether the presence of CRAB factors has an influence on the prognosis of myeloma treated with novel agents. In the current study, patients with hypercalcemia and bone disease showed a significantly worse prognosis, whereas anemia and renal failure showed no difference in survival. Novel agents used for treatment of patients with renal failure suggested a favorable outcome compared with conventional therapy. Bone disease was the most common factor and may have the strongest prognostic value in symptomatic myeloma patients using novel agents.
首字母缩略词CRAB概括了多发性骨髓瘤最典型的临床表现，即高钙血症、肾衰竭、贫血和骨病。CRAB可用于区分活动性、有症状的多发性骨髓瘤与意义未明的单克隆丙种球蛋白病或冒烟型骨髓瘤。这种区分不仅与分类和诊断有关，还与治疗有关。CRAB因素会影响多发性骨髓瘤的预后。然而，尚不清楚CRAB因素的存在是否会对使用新型药物治疗的骨髓瘤患者的预后产生影响。在当前研究中，高钙血症和骨病患者的预后明显较差，而贫血和肾衰竭患者的生存率没有差异。用于治疗肾衰竭患者的新型药物与传统疗法相比显示出良好的疗效。骨病是最常见的因素，在使用新型药物的有症状骨髓瘤患者中可能具有最强的预后价值。
