Haematology Department, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban, KwaZulu-Natal, South Africa.
Haematology Department, National Health Laboratory Services, Durban, KwaZulu-Natal, South Africa.
PLoS One. 2023 Oct 25;18(10):e0287304. doi: 10.1371/journal.pone.0287304. eCollection 2023.
To profile the outcome of multiple myeloma (MM) patients treated at a South African tertiary hospital in KwaZulu-Natal (KZN) and to compare MM in HIV-negative patients and MM in people living with HIV (PLWH).
A retrospective analysis of patients with MM was conducted over 5 years (2015-2020). Patient demographics, presenting complaints, symptom duration, disease stage, molecular profile, treatment, and survival data were captured. Statistical analysis was conducted using R Statistical software of the R Core Team, 2020, version 3.6.3.
135 patients; 79% (n = 106) HIV-negative and 21% (n = 29) PLWH were investigated. 54% (n = 74) females and 57% (n = 76) 51-70-year-olds. The 40-50-year-old patient group had a significantly higher proportion of PLWH (p = 0.032). Pathological fractures were the commonest presenting complaint, 47% (n = 57 and 49% (n = 49) had International Staging System, stage III disease. Fluorescent in-situ hybridization (FISH) MM profiling was completed in 58% (n = 78). Positivity for del 11q22 was found in 23.7% (n = 14) with significantly more HIV-negative patients having the mutation (p = 0.027). Overall, 42.2% (n = 57) achieved 2-year overall survival (OS). There were no significant differences in treatment (p = 0.926) and 2-year survival outcome (p = 0.792) between the two groups.
The incidence of HIV in newly diagnosed MM patients in KZN was increasing. KZN patient profile differed from other reports by showing female predominance but was similar in advanced-stage presentation and bone fracture predominance. Statistically significant differences between the HIV-negative patients and PLWH were observed in age distribution and mutational landscape. Further studies are required in this area.
分析在夸祖鲁-纳塔尔省（KZN）一家南非三级医院治疗的多发性骨髓瘤（MM）患者的结局，并比较 HIV 阴性患者和 HIV 感染者（PLWH）的 MM。
对 5 年来（2015-2020 年）的 MM 患者进行回顾性分析。采集患者的人口统计学资料、临床表现、症状持续时间、疾病分期、分子特征、治疗和生存数据。统计分析使用 R 统计软件的 R 核心团队 2020 年 3.6.3 版本进行。
共纳入 135 例患者，79%（n=106）为 HIV 阴性，21%（n=29）为 PLWH。女性占 54%（n=74），51-70 岁者占 57%（n=76）。40-50 岁患者中 PLWH 比例显著更高（p=0.032）。病理性骨折是最常见的临床表现，47%（n=57）和 49%（n=49）的患者国际分期系统（ISS）分期为 III 期。58%（n=78）完成了荧光原位杂交（FISH）MM 分析。11q22 缺失的阳性率为 23.7%（n=14），HIV 阴性患者的突变明显更多（p=0.027）。总体而言，42.2%（n=57）的患者达到 2 年总生存（OS）。两组在治疗（p=0.926）和 2 年生存结果（p=0.792）方面无显著差异。
KZN 新诊断 MM 患者中 HIV 的发病率在增加。KZN 患者的特征与其他报告不同，表现为女性为主，但在晚期表现和骨骨折为主方面相似。HIV 阴性患者和 PLWH 之间在年龄分布和突变景观方面观察到显著差异。该领域需要进一步研究。
