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多发性骨髓瘤患者生存中疾病相关并发症的患病率、结局及影响

Prevalence, Outcomes and Impact of Disease-Related Complications in the Survival of Multiple Myeloma Patients.

作者信息

Tothong Wachiralak, Tantiworawit Adisak, Norasetthada Lalita, Chai-Adisaksopha Chatree, Punnachet Teerachat, Hantrakun Nonthakorn, Piriyakhuntorn Pokpong, Rattanathammethee Thanawat, Hantrakool Sasinee, Rattarittamrong Ekarat

机构信息

Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.

出版信息

Hematol Rep. 2024 Feb 21;16(1):89-97. doi: 10.3390/hematolrep16010009.

Abstract

There are limited data regarding the impact of disease-related complications on the survival of multiple myeloma (MM) patients. The primary objective of this study was to determine the prevalence of disease-related complications, including hypercalcemia, renal insufficiency, anemia, and bone lytic lesions in MM patients. The secondary objectives were to determine clinical characteristics, treatment outcomes, and the association of disease-related complications and mortality. A retrospective chart review of MM patients from November 2014 to December 2019 was conducted. A total of 200 MM patients were enrolled. The median age at diagnosis was 63 years. The bone lytic lesion was the most common disease-related complication found in 85% during first-line therapy, followed by anemia (71.5%), renal insufficiency (28.5%), and hypercalcemia (20%). While anemia was the most common complication during the second (51.2%) and third-line therapy (72%). The development of skeletal-related events (SREs) after treatment is a disease-related complication that is associated with decreased overall survival (HR 4.030, 95% CI 1.97-8.24, < 0.001). The most common disease-related complication of MM at initial diagnosis is bone lytic lesions, whereas anemia is more common with subsequent relapses. The presence of SRE after treatment is associated with the increased mortality of MM patients.

摘要

关于疾病相关并发症对多发性骨髓瘤(MM)患者生存的影响,相关数据有限。本研究的主要目的是确定疾病相关并发症的发生率,包括MM患者的高钙血症、肾功能不全、贫血和骨溶解病变。次要目的是确定临床特征、治疗结果以及疾病相关并发症与死亡率之间的关联。对2014年11月至2019年12月期间的MM患者进行了回顾性病历审查。共纳入200例MM患者。诊断时的中位年龄为63岁。骨溶解病变是一线治疗期间发现的最常见的疾病相关并发症,85%的患者出现该并发症,其次是贫血(71.5%)、肾功能不全(28.5%)和高钙血症(20%)。而贫血是二线治疗(51.2%)和三线治疗(72%)期间最常见的并发症。治疗后骨骼相关事件(SREs)的发生是一种与总生存期降低相关的疾病相关并发症(HR 4.030,95%CI 1.97 - 8.24,<0.001)。MM初始诊断时最常见的疾病相关并发症是骨溶解病变,而贫血在随后复发时更为常见。治疗后SRE的存在与MM患者死亡率增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b623/10969878/a029b2dc1ae3/hematolrep-16-00009-g001.jpg

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