Bataille R, Donadio D, Morlock G, Rosenberg F, Blotman F, Sany J, Simon L, Izarn P, Serre H
Rev Rhum Mal Osteoartic. 1979 Feb;46(2):77-83.
The authors have made a retrospective study of 243 cases of multiple myelomas, most of them treated with alkylating agents. The average age at the time of diagnosis was 65 years (+ 10). The ratio of the sexes was 1 : 1. Seventy two per cent of the patients had a bone rating of 2 or 3 according to the criteria of Durie and Salmon. Fifty-eight per cent of the patients were anemic (Hg 12 g per cent), with less than 15 per cent being leucopenic or thrombopenic. Hypercalcemia (105 mg 0/00) was noted in 27 per cent of cases. The distribution of immunochemical types is as follows : IgG, 51.5 per cent; IgA, 28 per cent; pure Bence Jones, 20.5 per cent. The respective percentages of kappa and lambda light chains were 64.2 per cent and 35.8 per cent. In this series, nearly 80 per cent of the patients were at phase III according to the classification of Durie and Salmon, and 30.8 per cent at phase B. The median survival, including all phases, increased from 8 months without alkylating agent, to 20 months with melphalan and/or cyclophosphamide. The factors influencing the survival of the patients treated were age, the hemoglobin level, calcemia, renal deficiencies, the immunochemical type, the stage of the disease, and the response to alkylating treatment. The value of these different prognostic factors is discussed.
作者对243例多发性骨髓瘤患者进行了回顾性研究，其中大多数患者接受了烷化剂治疗。诊断时的平均年龄为65岁（±10岁）。男女比例为1∶1。根据Durie和Salmon的标准，72%的患者骨分级为2级或3级。58%的患者贫血（血红蛋白12克/百分比），白细胞减少或血小板减少的患者不到15%。27%的病例出现高钙血症（105毫克/千分比）。免疫化学类型分布如下：IgG型占51.5%；IgA型占28%；单纯本-周蛋白型占20.5%。κ和λ轻链的各自百分比分别为64.2%和35.8%。在该系列中，根据Durie和Salmon的分类，近80%的患者处于Ⅲ期，30.8%处于B期。包括所有阶段在内的中位生存期，从未使用烷化剂时的8个月，增加到使用美法仑和/或环磷酰胺时的20个月。影响接受治疗患者生存的因素有年龄、血红蛋白水平、血钙、肾功能不全、免疫化学类型、疾病分期以及对烷化剂治疗的反应。讨论了这些不同预后因素的价值。
