Franco M, Fuzibet J G, Cassuto J P, Pesce A, Ziegler G, Dujardin P
Rev Rhum Mal Osteoartic. 1985 Nov;52(11):619-23.
A series of 21 patients with multiple myeloma and a survival of more than 5 years was compared to another series of 70 cases of myeloma, which all died within less than 5 years. The statistical analysis of these two groups revealed six factors with a significant prognostic value. The population with a long term survival presented: a low incidence of large tumour masses (stage III according to Durie and Salmon's classification): 24 per cent compared with 72 per cent p less than 0.01); a frequency on asymptomatic or minimally symptomatic forms of 29 per cent versus 7 per cent in the control series (p less than 0.001); a haemoglobin level of 7.3 mmol/l versus 6.4 mmol/l (p less than 0.01); a low beta-2-microglobulin level (4 mg/l versus 11 mg/l) (p less than 0.02); a usually normal serum creatinine level (p less than 0.05). Retrospectively, the authors also observed that the response to treatment constituted an essential prognostic factor (69 per cent response compared with 20 per cent) (p less than 0.001). The serum calcium, the immunological type, the level of monoclonal component and the marrow plasmocytosis did not differ between the two groups. The authors consider all of these parameters, together with the calcitonin hypocalcaemia test to be useful in three situations: the therapeutic decision in minimally symptomatic patients, the choice between single agent or combination chemotherapy, the establishment of criteria of remission and suspension of treatment.
将一组21例存活超过5年的多发性骨髓瘤患者与另一组70例骨髓瘤患者进行了比较，后者均在不到5年内死亡。对这两组患者的统计分析显示有六个因素具有显著的预后价值。长期存活的患者群体表现为：大肿瘤块的发生率较低（根据Durie和Salmon分类为III期）：24%，而对照组为72%（p<0.01）；无症状或症状轻微形式的发生率为29%，而对照组为7%（p<0.001）；血红蛋白水平为7.3 mmol/l，而对照组为6.4 mmol/l（p<0.01）；β2-微球蛋白水平较低（4 mg/l对11 mg/l）（p<0.02）；血清肌酐水平通常正常（p<0.05）。回顾性分析时，作者还观察到对治疗的反应是一个重要的预后因素（反应率为69%，而对照组为20%）（p<0.001）。两组之间的血清钙、免疫类型、单克隆成分水平和骨髓浆细胞增多情况没有差异。作者认为所有这些参数，连同降钙素低钙血症试验，在三种情况下有用：症状轻微患者的治疗决策、单药化疗或联合化疗的选择、缓解标准的确定和治疗的暂停。
