Buckman R, Cuzick J, Galton D A
Br J Haematol. 1982 Dec;52(4):589-99. doi: 10.1111/j.1365-2141.1982.tb03935.x.
The patients entered into the Medical Research Council's First Myelomatosis Trial (MRCI) have been followed up for a minimum of 12 years, and an attempt has been made to define features recorded at presentation that might predict long-term survival and to estimate the risk of acute myeloid leukaemia (AML) induced by treatment with either of the alkylating agents, melphalan or cyclophosphamide. In this series, the chance of a patient surviving 5 years was strongly related to the haemoglobin, blood urea concentration (BUC) and performance status at presentation. Other features, including paraprotein levels, type of heavy or light chain, bone lesions and recovery of polyclonal immunoglobulin added little useful information. Six patients died of AML, all after more than 4 years in the trial; the incidence of AML among 4-year survivors was 10%. All six patients had been treated with continuous melphalan and the implications of this for future chemotherapy for myelomatosis are discussed.
参加医学研究委员会首次骨髓瘤试验（MRCI）的患者已接受了至少12年的随访，并且已尝试确定在就诊时记录的可能预测长期生存的特征，并评估使用烷化剂美法仑或环磷酰胺治疗诱发急性髓细胞白血病（AML）的风险。在该系列研究中，患者存活5年的几率与就诊时的血红蛋白、血尿素浓度（BUC）和体能状态密切相关。其他特征，包括副蛋白水平、重链或轻链类型、骨病变和多克隆免疫球蛋白的恢复情况，几乎没有增加有用信息。6例患者死于AML，均在试验进行4年多之后；4年幸存者中AML的发生率为10%。所有6例患者均接受了持续美法仑治疗，并讨论了这对未来骨髓瘤化疗的影响。
