Department of Hematology, Ome Municipal General Hospital, Japan.
Department of Orthopedics, Ome Municipal General Hospital, Japan.
Intern Med. 2021 Apr 15;60(8):1169-1174. doi: 10.2169/internalmedicine.5466-20. Epub 2020 Nov 23.
Objective Patients with hematological malignancies, particularly those with multiple myeloma, often suffer from pathological vertebral compression fractures (VCFs). Consequent and significant spinal pain and paralysis impair the activities of daily living and quality of life and delay subsequent chemotherapy. Balloon kyphoplasty (BKP), which is less invasive than conventional therapies, is a type of percutaneous vertebroplasty in which cement is injected into the broken vertebrae to stabilize the spinal column. The present study assessed the effect of BKP on hematological tumors. Methods We retrospectively analyzed five myeloma patients and one lymphoma patient who underwent BKP for pathological VCFs in our institution. Results The median age was 74 years old. The spinal operation level ranged from T2 to L4. BKP was performed at the diagnosis in two cases, after first-line chemotherapy in one case, and after subsequent chemotherapy in three cases. After approximately 1 month, the patients' average Eastern Cooperative Oncology Group performance status score rapidly improved from 3.2 to 1.3. The numeric rating scale score decreased from 8.8 to 2.0, and the Karnofsky Performance Status score increased from 35 to 75. No severe complications were observed. All patients became able to walk unassisted and underwent early subsequent chemotherapy. Conclusion BKP can be a safe and effective treatment option for pathological VCFs in patients with hematological malignancies and allows for rapid induction with subsequent chemotherapy.
目的 血液系统恶性肿瘤患者，尤其是多发性骨髓瘤患者，常发生病理性椎体压缩性骨折（VCF）。由此导致的严重脊柱疼痛和瘫痪会影响日常生活活动和生活质量，并延迟后续的化疗。球囊扩张椎体后凸成形术（BKP）是一种比传统治疗方法更具侵入性的经皮椎体成形术，它将水泥注入骨折的椎体中以稳定脊柱。本研究评估了 BKP 对血液系统肿瘤的治疗效果。 方法 我们回顾性分析了在我院因病理性 VCF 接受 BKP 的 5 例骨髓瘤患者和 1 例淋巴瘤患者。 结果 患者的中位年龄为 74 岁，脊柱手术部位从 T2 到 L4 不等。有 2 例在诊断时即进行了 BKP，1 例在一线化疗后进行，3 例在后续化疗后进行。大约 1 个月后，患者的东部肿瘤协作组（ECOG）体力状况评分平均从 3.2 迅速提高至 1.3。数字评分量表（NRS）评分从 8.8 降至 2.0，卡氏功能状态评分（KPS）从 35 提高至 75。未观察到严重并发症。所有患者均能独立行走，并能尽早进行后续化疗。 结论 BKP 是血液系统恶性肿瘤患者病理性 VCF 的一种安全有效的治疗选择，可迅速缓解症状并进行后续化疗。
