[新型药物时代原发性浆细胞白血病预后因素分析]
[Analysis of the prognostic factors in primary plasma cell leukemia in the era of novel agents].
作者信息
Deng J J, Jin X Y, Zhang Z Y, Zhou H X, Yang G Z, Geng C Y, Jian Y, Chen W M, Gao W
机构信息
Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China.
出版信息
Zhonghua Xue Ye Xue Za Zhi. 2024 Jul 14;45(7):645-650. doi: 10.3760/cma.j.cn121090-20240129-00042.
To explore the prognostic factors of primary plasma cell leukemia (pPCL) in the era of novel agents. The clinical data of 66 patients with pPCL treated at the Department of Haematology, Beijing Chao-Yang Hospital, Capital Medical University from 2011 to 2022 were retrospectively collected to analyze their prognostic factors. Among the 66 patients with pPCL, the median age was 59 (range: 29-79) years. The median overall survival (OS) duration was 19.0 (95% 10.4-27.6) months, and the median progression-free survival (PFS) duration was 11.0 (95% 6.5-15.6) months. The median OS and PFS were significantly longer in patients with the best post-treatment response of very good partial remission (VGPR) or better than in patients with a response of partial remission (PR) or worse (median OS: 33.0 months 6.0 months, <0.001; median PFS: 16.0 months 3.0 months, <0.001). OS was significantly longer in patients who underwent autologous hematopoietic stem cell transplantation than in those who did not undergo transplantation (49.0 months 6.0 months, =0.002), and there was a trend toward a longer PFS in patients who underwent transplantation than in those who did not undergo transplantation (19.0 months 8.0 months, =0.299). The median OS and PFS were significantly longer in patients who received maintenance therapy than in those who did not receive maintenance therapy (median OS: 56.0 months 4.0 months, <0.001; median PFS: 20.0 months 2.0 months, <0.001). Multivariate analysis showed that hypercalcemia was an independent risk factor (=3.204, 95% 1.068-9.610, =0.038) for patients with pPCL, while receiving maintenance therapy (=0.075, 95% 0.022-0.253, <0.001) and post-treatment response of VGPR or better (=0.175, 95% 0.048-0.638, =0.008) were independent protective factors for patients with pPCL. In the era of novel agents, hypercalcemia, receiving maintenance therapy, and post-treatment response of VGPR or better are independent prognostic factors for pPCL.
探索新型药物时代原发性浆细胞白血病（pPCL）的预后因素。回顾性收集2011年至2022年在首都医科大学附属北京朝阳医院血液科接受治疗的66例pPCL患者的临床资料，分析其预后因素。66例pPCL患者的中位年龄为59岁（范围：29 - 79岁）。中位总生存期（OS）为19.0（95% 10.4 - 27.6）个月，中位无进展生存期（PFS）为11.0（95% 6.5 - 15.6）个月。治疗后最佳反应为非常好的部分缓解（VGPR）或更好的患者，其OS和PFS的中位数显著长于部分缓解（PR）或更差反应的患者（中位OS：33.0个月 6.0个月，<0.001；中位PFS：16.0个月 3.0个月，<0.001）。接受自体造血干细胞移植的患者OS显著长于未接受移植的患者（49.0个月 6.0个月，=0.002），接受移植的患者PFS有长于未接受移植患者的趋势（19.0个月 8.0个月，=0.299）。接受维持治疗的患者OS和PFS的中位数显著长于未接受维持治疗的患者（中位OS：56.0个月 4.0个月，<0.001；中位PFS：20.0个月 2.0个月，<0.001）。多因素分析显示，高钙血症是pPCL患者的独立危险因素（=3.204，95% 1.068 - 9.610，=0.038），而接受维持治疗（=0.075，95% 0.022 - 0.253，<0.001）和治疗后反应为VGPR或更好（=0.175，95% 0.048 - 0.638，=0.008）是pPCL患者的独立保护因素。在新型药物时代，高钙血症、接受维持治疗以及治疗后反应为VGPR或更好是pPCL的独立预后因素。
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