Scudla V, Indrák K
Neoplasma. 1985;32(4):469-79.
A group of 193 patients with multiple myeloma (MM) consisting of cases treated only symptomatically or by nonsystematic therapy with Cyclophosphamide or Melphalan (1959-76), and of patients given systematic polychemotherapy with intensive supportive treatment (1976-84) were subjected to prognostic analysis of the importance of MM stratification into two categories, poor and good risk. The evaluation included only hitherto untreated patients with MM of the IgG, IgA, and Bence-Jones' types. All the three evaluated stratification systems (ALGB, NCI-SECSG and CALGB) were found in the present study to show a good, equally significant relation to the prognosis of the disease. The survival median of poor risk patients in terms of the used classification system for the 1959-76 subgroup was 5-6 months, for the 1976-84 subgroup 20-22 months. In the good risk category it was 24-27 months in the 1959-76 subgroup and 47-50 months in the 1976-84 subgroup. Permanent validity of the initial prognosis and in the poor risk category safe coverage of patients with a high risk of early death was proved. Good agreement of the studied stratification systems with the clinical staging system of Durie and Salmon [14] (most of the Stage III patients consisted of poor risk patients) was recorded, which, however, was not the case with the staging system of Merlini, Waldenström and Jayakar [27]. The CALGB system is considered the most suited to the needs of clinical practice.
一组193例多发性骨髓瘤（MM）患者接受了预后分析，该组患者包括仅接受对症治疗或采用环磷酰胺或美法仑进行非系统性治疗的病例（1959 - 1976年），以及接受系统性多药化疗并强化支持治疗的患者（1976 - 1984年），分析了将MM分为预后不良和预后良好两类的重要性。评估仅纳入了IgG、IgA和本-周蛋白型的初治MM患者。在本研究中发现，所有三种评估的分层系统（ALGB、NCI - SECSG和CALGB）均与该疾病的预后呈现出良好且同样显著的关系。就所使用的分类系统而言，1959 - 1976年亚组中预后不良患者的中位生存期为5 - 6个月，1976 - 1984年亚组为20 - 22个月。在预后良好类别中，1959 - 1976年亚组为24 - 27个月，1976 - 1984年亚组为47 - 50个月。证明了初始预后的长期有效性以及在预后不良类别中对早期死亡高风险患者的安全覆盖。记录了所研究的分层系统与Durie和Salmon的临床分期系统[14]具有良好的一致性（大多数III期患者为预后不良患者），然而，Merlini、Waldenström和Jayakar的分期系统[27]并非如此。CALGB系统被认为最适合临床实践的需求。
