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存活超过10年的多发性骨髓瘤患者的特征。

The characteristics of patients with multiple myeloma surviving over 10 years.

作者信息

Huang Beihui, Zhang Hongning, Liu Junru, Gu Jingli, Chen Meilan, Kuang Lifen, Li Xiaozhe, Li Juan

机构信息

Department of Hematology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Front Oncol. 2024 Nov 21;14:1490630. doi: 10.3389/fonc.2024.1490630. eCollection 2024.

Abstract

OBJECTIVE

To explore the characteristics of patients with multiple myeloma (MM) who have achieved long-term survival of over 10 years in the context where novel agents and autologous stem cell transplantation (ASCT) serve as the primary therapeutic modalities.

METHODS

A retrospective analysis was conducted on 168 MM patients diagnosed and treated in our institution from January 2004 to January 2014. 44 patients with a survival period exceeding 10 years were categorized into the long-term survival group, while 124 patients with a survival period of less than 10 years were categorized into the non-long-term survival group.

RESULTS

Being younger than 57 years old (OR 3.634, 95%CI 1.302-10.143), having a neutrophil count of at least 3.66 * 10/L (OR 3.122, 95% CI 1.093-8.918), absence of high-risk genetic abnormalities (OR 7.146, 95%CI 1.066-47.904), and receiving frontline ASCT (OR 4.225, 95%CI 1.000-17.841) were positively associated with a survival period exceeding 10 years in patients with MM. Achieving sustained minimal residual disease (MRD) negativity for at least 24 months is associated with long-term survival regardless of the presence of high-risk cytogenetic abnormalities.

CONCLUSION

Being younger, having a neutrophil count above 3.66 * 10/L, the absence of high-risk cytogenetic abnormalities, and receiving frontline ASCT are independent protective factors for transplant-eligible MM patients to survive more than 10 years. Achieving maintained MRD negativity status for over 24 months might be associated with long-term survival.

摘要

目的

在新型药物和自体干细胞移植(ASCT)作为主要治疗方式的背景下,探讨多发性骨髓瘤(MM)患者实现超过10年长期生存的特征。

方法

对2004年1月至2014年1月在我院诊断和治疗的168例MM患者进行回顾性分析。将44例生存期超过10年的患者归入长期生存组,124例生存期不足10年的患者归入非长期生存组。

结果

年龄小于57岁(比值比[OR] 3.634,95%置信区间[CI] 1.302 - 10.143)、中性粒细胞计数至少为3.66×10⁹/L(OR 3.122,95% CI 1.093 - 8.918)、不存在高危基因异常(OR 7.146,95% CI 1.066 - 47.904)以及接受一线ASCT(OR 4.225,95% CI 1.000 - 17.841)与MM患者生存期超过10年呈正相关。无论是否存在高危细胞遗传学异常,实现持续微小残留病(MRD)阴性至少24个月与长期生存相关。

结论

年龄较轻、中性粒细胞计数高于3.66×10⁹/L、不存在高危细胞遗传学异常以及接受一线ASCT是符合移植条件的MM患者存活超过10年的独立保护因素。实现超过24个月的MRD阴性状态维持可能与长期生存相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/524a/11617579/4252fb3fecfd/fonc-14-1490630-g001.jpg

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