Cavo M, Baccarani M, Galieni P, Gobbi M, Tura S
Nouv Rev Fr Hematol (1978). 1986;28(3):147-52.
The presenting clinical features, response to treatment and survival duration of 26 consecutive multiple myeloma patients with renal failure at diagnosis were investigated. All but 1 of the patients had high tumour cell mass stage, as identified by one (3 cases) or more (22 cases) of the criteria defined by Durie and Salmon. Survival length of azotaemic patients was significantly shorter than that of stage III patients with normal renal function (median: 4 months vs 41 months, respectively, P less than 0.0005), and was positively affected by reversal of renal failure following treatment (P less than 0.0005). Of the 26 patients, 56% achieved reversal of renal failure. Recovery of normal renal function was prompt in most of the cases and appeared to be independent from both M component type and pretreatment serum creatinine levels. Finally, it was shown that patients with reversible renal impairment but with myeloma unresponsive to alkylating agents had early recurrence of impaired renal function and a shorter life expectancy than patients with a significant decrease in tumour cell mass.
对26例诊断时伴有肾衰竭的连续性多发性骨髓瘤患者的临床特征、治疗反应及生存期进行了研究。除1例患者外，所有患者均处于高肿瘤细胞负荷期，这是根据Durie和Salmon定义的一项标准（3例）或多项标准（22例）确定的。氮质血症患者的生存期明显短于肾功能正常的III期患者（中位数分别为4个月和41个月，P<0.0005），且治疗后肾衰竭的逆转对生存期有积极影响（P<0.0005）。26例患者中，56%实现了肾衰竭的逆转。大多数病例中肾功能恢复迅速，且似乎与M成分类型和治疗前血清肌酐水平无关。最后，研究表明，肾功能损害可逆但骨髓瘤对烷化剂无反应的患者，其肾功能损害早期复发，预期寿命比肿瘤细胞负荷显著降低的患者短。
