Ishii H
Second Department of Internal Medicine, Okayama University Medical School, Japan.
Acta Med Okayama. 1988 Oct;42(5):279-86. doi: 10.18926/AMO/31024.
Patients with multiple myeloma were treated chemotherapeutically with a combination of melphalan, ifosfamide, prednisolone, nitrosourea and vincristine (MIP-NV therapy). The M-protein kinetics during the course of MIP-NV therapy was studied. The kinetics of serum and urinary M-protein in the first cycle of the chemotherapy was classified into four patterns, and the mode of change in the M-protein level over the entire course of chemotherapy was classified into four prototypes. There were intimate relationships among M-protein kinetics patterns in the first cycle of the chemotherapy, the effect of the chemotherapy on M-protein reduction, maturity of myeloma cells, pretreatment labeling index and clinical stage of the disease. Moreover, analyzing the prototypes, it was found that both the time for maximum M-protein reduction and the rate of increase in the M-protein level after maximum M-protein reduction affected the survival time. To predict the effect of the chemotherapy on M-protein reduction and survival time, it was useful to analyze subgroups, which were classified according to the M-protein kinetics pattern in the first cycle, the time for maximum M-protein reduction and the rate of increase in the M-protein level after maximum M-protein reduction.
多发性骨髓瘤患者接受了美法仑、异环磷酰胺、泼尼松龙、亚硝基脲和长春新碱联合化疗（MIP-NV疗法）。研究了MIP-NV疗法过程中的M蛋白动力学。化疗第一个周期中血清和尿M蛋白的动力学分为四种模式，化疗全过程中M蛋白水平的变化模式分为四种原型。化疗第一个周期的M蛋白动力学模式、化疗对M蛋白减少的影响、骨髓瘤细胞的成熟度、预处理标记指数和疾病临床分期之间存在密切关系。此外，通过分析这些原型发现，M蛋白最大减少时间和M蛋白最大减少后水平的增加速率均影响生存时间。为预测化疗对M蛋白减少和生存时间的影响，根据化疗第一个周期的M蛋白动力学模式、M蛋白最大减少时间和M蛋白最大减少后水平的增加速率对亚组进行分类分析是有用的。
