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初诊多发性骨髓瘤患者血清骨代谢指标与骨病及生存的相关性。

The correlation between serum bone metabolism indexes and bone disease and survival in newly diagnosed multiple myeloma patients.

机构信息

Bone Marrow Transplantation Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China.

出版信息

Cancer Biol Ther. 2024 Dec 31;25(1):2403205. doi: 10.1080/15384047.2024.2403205. Epub 2024 Sep 18.

Abstract

UNLABELLED

Objective Myeloma-related bone disease (MBD) is one of the most common complications of multiple myeloma (MM). This study aims to investigate the correlation between serum bone metabolism indexes (BMIs), the clinical characteristics and prognosis of newly diagnosed MM (NDMM) patients.

METHODS

The serum BMIs of 148 patients with NDMM in a single hematological disease treatment center from April 2014 to December 2019 were analyzed retrospectively, including type I collagen amino terminal elongation peptide (PINP), β-C-terminal telopeptide of type I collagen (β-CTX) and N-terminal osteocalcin (N-MID). Other clinical indexes were simultaneously collected and the degree of bone damage in patients was evaluated. We explored the effect of serum BMIs on the prognosis and identified independent prognostic factors. Another 77 NDMM patients from April 2018 to February 2021 served as the validation cohort.

RESULTS

The area under the curve (AUC) predicted by β-C-terminal telopeptide of type I collagen (β-CTX), type I collagen amino terminal elongation peptide (PINP), and N-terminal osteocalcin (N-MID) for overall survival (OS) were 0.708, 0.613, and 0.538, respectively. Patients with high serum levels had shorter OS ( < .001,  = .004,  = .027, respectively). Cox multivariate analysis indicated that serum β- CTX、lactic dehydrogenase、hemoglobin and the degree of bone injury were independent prognostic factors. A COX regression model was established with a C-index of 0.782 and validated with a C-index of 0.711.

CONCLUSION

The serum BMIs are correlated with the patients' OS, and β- CTX can be an independent prognostic factor.

摘要

目的

骨髓瘤相关骨病(MBD)是多发性骨髓瘤(MM)最常见的并发症之一。本研究旨在探讨血清骨代谢指标(BMIs)与新诊断 MM(NDMM)患者临床特征和预后的相关性。

方法

回顾性分析了 2014 年 4 月至 2019 年 12 月在单一血液疾病治疗中心的 148 例 NDMM 患者的血清 BMIs,包括Ⅰ型胶原氨基端延长肽(PINP)、Ⅰ型胶原β-端肽(β-CTX)和 N-端骨钙素(N-MID)。同时收集了其他临床指标,并对患者的骨损伤程度进行了评估。我们探讨了血清 BMIs 对预后的影响,并确定了独立的预后因素。另一个 77 例 NDMM 患者来自 2018 年 4 月至 2021 年 2 月,作为验证队列。

结果

Ⅰ型胶原β-端肽(β-CTX)、Ⅰ型胶原氨基端延长肽(PINP)和 N-端骨钙素(N-MID)预测总生存期(OS)的曲线下面积(AUC)分别为 0.708、0.613 和 0.538。血清水平较高的患者 OS 更短( < .001, = .004, = .027)。Cox 多因素分析表明,血清β-CTX、乳酸脱氢酶、血红蛋白和骨损伤程度是独立的预后因素。建立了 COX 回归模型,C 指数为 0.782,并通过 C 指数为 0.711 进行了验证。

结论

血清 BMIs 与患者的 OS 相关,β-CTX 可以作为一个独立的预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6374/11649219/9907c11a3fd6/KCBT_A_2403205_F0001_OC.jpg

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