Yan W W, Fan H S, Xu J Y, Liu J H, Du C X, Deng S H, Sui W W, Xu Y, Qiu L G, An G
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
Zhonghua Nei Ke Za Zhi. 2022 Jul 1;61(7):801-805. doi: 10.3760/cma.j.cn112138-20210908-00626.
The clinical characteristics, laboratory results, response to treatment, and prognosis of 46 macrofocal multiple myeloma(MFMM) patients at our center from January 2013 to December 2019 were analyzed retrospectively. The other 92 patients were selected as matched-controls based on diagnostic period and treatment. Among the 1 137 MM patients, 46 patients met the definition criteria of MFMM (4.0%), with median age 56 years, which was not statistically different from whole MM population (=0.066). According to the international staging system (ISS) and Revised ISS, the proportion of patients with advanced stage in MFMM group was less common than that of controls (<0.05). More plasmacytomas in MFMM patients were presented (43.5% vs. 18.5%, <0.05). Regarding cytogenetic abnormalities, there were minor patients manifesting high-risk features in MFMM group (15.8% vs. 32.2%, =0.058). Translocation(11;14) could be detected in 32.4% MFMM patients and 9.4% typical myeloma patients (<0.05). The treatment regimens were comparable. As to the best response of treatment, the complete response (CR) rate in MFMM group was significantly higher than that of controls (78.3% vs. 60.9%, <0.05). The median follow-up time was 37.9 months. The median progression-free survival in MFMM and control groups were 77.5 vs. 39.8 months, respectively (<0.05). The overall survival (OS) of MFMM patients was significantly longer (not reached vs. 68.2 months, <0.05).
回顾性分析了2013年1月至2019年12月在本中心就诊的46例巨灶性多发性骨髓瘤（MFMM）患者的临床特征、实验室检查结果、治疗反应及预后。另外选取92例患者作为诊断时期和治疗相匹配的对照。在1137例MM患者中，46例符合MFMM的定义标准（4.0%），中位年龄56岁，与整个MM患者群体相比无统计学差异（P=0.066）。根据国际分期系统（ISS）和修订的ISS，MFMM组晚期患者比例低于对照组（P<0.05）。MFMM患者中浆细胞瘤更多见（43.5%对18.5%，P<0.05）。关于细胞遗传学异常，MFMM组表现出高危特征的患者较少（15.8%对32.2%，P=0.058）。32.4%的MFMM患者可检测到t(11;14)，典型骨髓瘤患者中这一比例为9.4%（P<0.05）。治疗方案具有可比性。就治疗的最佳反应而言，MFMM组的完全缓解（CR）率显著高于对照组（78.3%对60.9%，P<0.05）。中位随访时间为37.9个月。MFMM组和对照组的中位无进展生存期分别为77.5个月和39.8个月（P<0.05）。MFMM患者的总生存期显著更长（未达到对68.2个月，P<0.05）。
