新诊断的多发性骨髓瘤患者初始碱性磷酸酶水平与总生存期的相关性。
Correlation between initial alkaline phosphatase levels and overall survival in newly diagnosed multiple myeloma patients.
作者信息
Tan Jie, Liu Jun-Peng, Yao Xing-Chen, Xu Zi-Yu, Wu Yue, Shi Xiang-Jun, Shi Ming, Li Meng, Du Xin-Ru
机构信息
Department of Hematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of General Practice, Liyuan Community Health Service Center, Beijing, China.
出版信息
Transl Cancer Res. 2024 Jul 31;13(7):3328-3337. doi: 10.21037/tcr-24-330. Epub 2024 Jul 23.
BACKGROUND
Alkaline phosphatase (ALP) reflects changes in the condition of multiple myeloma (MM) patients to some extent. However, the relationship of ALP in MM remains uncertain. Our study aimed to determine the association between initial ALP levels and overall survival in newly diagnosed MM patients.
METHODS
Clinical data from 202 newly diagnosed MM patients at Beijing Chaoyang Hospital between 2012 and 2016 were collected. Baseline characteristics, disease progression staging, serum markers, and patient survival data were recorded. The cut-off value for ALP was calculated based on patient survival data, and patients were divided into groups. Differences in patients' 3- and 5-year survival rates, liver function, bone disease and other indicators among different groups were compared. Independent risk factors influencing newly diagnosed MM patients were identified using COX regression analysis.
RESULTS
Patients were categorized into three groups based on ALP cut-off points: Group 1 (ALP <70 U/L), Group 2 (ALP 70 to <120 U/L), and Group 3 (ALP ≥120 U/L). Significant differences were observed in lactate dehydrogenase, serum calcium, white blood cell count, hemoglobin, and liver function indicators (including alanine aminotransferase, aspartate aminotransferase, albumin, and γ-glutamyl transferase) among different ALP groups (P<0.05). ALP levels varied significantly among patients with different bone disease grades (P<0.05). Median survival times for Groups 1, 2, and 3 were 25, 52, and 31 months, respectively. Group 2 exhibited significantly higher 3-year survival compared to the other two groups (P=0.006), while no significant difference was observed in 5-year survival among the three groups (P=0.51). Age, International Staging System staging, aspartate aminotransferase, β2-microglobulin, ALP grading, and severe bone disease were identified as independent factors influencing survival in newly diagnosed patients (P<0.05).
CONCLUSIONS
ALP levels are correlated with the prognosis of MM patients, and an ALP range of 70 to <120 U/L reflects a better survival expectation.
背景
碱性磷酸酶（ALP）在一定程度上反映了多发性骨髓瘤（MM）患者病情的变化。然而，MM中ALP的关系仍不明确。我们的研究旨在确定新诊断MM患者初始ALP水平与总生存期之间的关联。
方法
收集了2012年至2016年在北京朝阳医院新诊断的202例MM患者临床资料。记录基线特征、疾病进展分期、血清标志物及患者生存数据。根据患者生存数据计算ALP的临界值，并将患者分组。比较不同组患者3年和5年生存率、肝功能、骨病及其他指标的差异。采用COX回归分析确定影响新诊断MM患者的独立危险因素。
结果
根据ALP临界值将患者分为三组：第1组（ALP<70 U/L）、第2组（ALP 70至<120 U/L）和第3组（ALP≥120 U/L）。不同ALP组间乳酸脱氢酶、血清钙、白细胞计数、血红蛋白及肝功能指标（包括丙氨酸转氨酶、天冬氨酸转氨酶、白蛋白和γ-谷氨酰转移酶）存在显著差异（P<0.05）。不同骨病分级患者的ALP水平差异显著（P<0.05）。第1组、第2组和第3组的中位生存时间分别为25个月、52个月和31个月。第2组的3年生存率显著高于其他两组（P=0.006），而三组间5年生存率无显著差异（P=0.51）。年龄、国际分期系统分期、天冬氨酸转氨酶、β2-微球蛋白、ALP分级及严重骨病被确定为影响新诊断患者生存的独立因素（P<0.05）。
结论
ALP水平与MM患者的预后相关，70至<120 U/L的ALP范围预示着更好的生存预期。
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