新诊断多发性骨髓瘤超高危患者的特征及危险因素
Characteristics and Risk Factors of Ultra-High-Risk Patients with Newly Diagnosed Multiple Myeloma.
作者信息
Geng Chuanying, Yang Guangzhong, Zhou Huixing, Wang Huijuan, Li Yanchen, Leng Yun, Zhang Zhiyao, Jian Yuan, Chen Wenming
机构信息
Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
出版信息
J Pers Med. 2023 Apr 14;13(4):666. doi: 10.3390/jpm13040666.
OBJECTIVE
To investigate the clinical characteristics and risk factors of ultra-high-risk (UHR) patients with newly diagnosed multiple myeloma (MM).
METHODS
We screened UHR patients with a survival of less than 24 months and we selected patients with a concurrent survival of more than 24 months as a control group. We retrospectively analyzed the clinical characteristics of UHR patients with newly diagnosed MM and screened related risk factors.
RESULTS
In total we analyzed 477 patients, which included 121 (25.4%) UHR patients and 356 (74.6%) control patients. Median overall survival (OS) and progression-free survival (PFS) of UHR patients was 10.5 months (7.5-13.5 months) and 6.3 months (5.4-7.2 months), respectively. Univariate logistic regression analysis showed that age > 65 years, hemoglobin (HGB) < 100 g/L, lactate dehydrogenase (LDH) > 250 U/L, serum creatinine (SCr) > 2 mg/dL, corrected serum calcium (CsCa) > 2.75 mmol/L, B-type natriuretic peptide (BNP) or N-terminal prohormone BNP (NT-proBNP) > 2 upper limit of normal (ULN), high-risk cytogenetics, Barthel index score, and International Staging System (ISS) stage III were associated with UHR MM. In a multivariate analysis, age > 65 years, LDH > 250 U/L, CsCa > 2.75 mmol/L, BNP or NT-proBNP > 2 ULN, high-risk cytogenetics, and Barthel index score were independent risk factors for UHR MM. Moreover, UHR patients had a worse response rate than control patients.
CONCLUSION
Our study highlighted the characteristics of UHR MM patients and suggested that the combination of organ insufficiency and highly malignant myeloma cells resulted in poor outcomes of patients with UHR MM.
目的
探讨新诊断的多发性骨髓瘤（MM）超高风险（UHR）患者的临床特征及危险因素。
方法
筛选生存时间小于24个月的UHR患者，并选取生存时间大于24个月的患者作为对照组。回顾性分析新诊断的MM的UHR患者的临床特征并筛选相关危险因素。
结果
共分析477例患者，其中包括121例（25.4%）UHR患者和356例（74.6%）对照患者。UHR患者的中位总生存期（OS）和无进展生存期（PFS）分别为10.5个月（7.5 - 13.5个月）和6.3个月（5.4 - 7.2个月）。单因素逻辑回归分析显示，年龄>65岁、血红蛋白（HGB）<100 g/L、乳酸脱氢酶（LDH）>250 U/L、血清肌酐（SCr）>2 mg/dL、校正血清钙（CsCa）>2.75 mmol/L、B型利钠肽（BNP）或N末端前体脑钠肽（NT-proBNP）>正常上限（ULN）的2倍、高危细胞遗传学、巴氏指数评分以及国际分期系统（ISS）III期与UHR-MM相关。多因素分析中，年龄>65岁、LDH>250 U/L、CsCa>2.75 mmol/L、BNP或NT-proBNP>ULN的2倍、高危细胞遗传学以及巴氏指数评分是UHR-MM的独立危险因素。此外，UHR患者的缓解率低于对照患者。
结论
我们的研究突出了UHR-MM患者的特征，并提示器官功能不全与高恶性骨髓瘤细胞共同导致UHR-MM患者预后不良。
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