Iakovleva S V, Andreeva N E, Izgorodin A S
Ter Arkh. 1995;67(7):35-9.
Serum levels of lactate dehydrogenase (LDG) and beta 2-microglobulin (beta 2-MG) were measured in 164 and 128 patients with multiple myeloma (MM), respectively. High levels of LDG were recordable in 15.4% of patients at diagnosis and 36.8% of terminal stage patients. The frequency of extraosseous foci in untreated patients with high LDG activity made up 36.8%, survival median 19 months. In normal LDG activity the above values were 6.8% and more than 36 months, respectively. The highest LDG level occurred in patients with terminal plasmic cell leukemia. MM with IgD secretion was characterized by a a more frequent rise in LDG concentrations. Normal LDG amounts in active MM were seen in 58 (54.2%) out of 107 patients. beta 2-MG levels exceeded 6 mg/l in 75 of 128 patients with normal creatinine. These patients had a short survival median 24 months. Those patients who had beta 2-MG levels under 6 mg/l have not reached survival median for 36 months of follow-up. The authors hold that beta 2-MG concentrations are of prognostic value in all myeloma secretions and in nonsecretory myeloma as well though their indications are not absolute as 14% had low beta 2-MG levels in high MM activity. Comparative results are presented for 40 high-risk MM patients. Group 1 (20 patients) have received standard chemotherapy. Group 2 (20 patients) have undergone intensive polychemotherapy. Survival median made up 12 and 26 months for group 1 and 2, respectively.
分别对164例和128例多发性骨髓瘤（MM）患者测定了血清乳酸脱氢酶（LDG）和β2-微球蛋白（β2-MG）水平。诊断时15.4%的患者和终末期患者中有36.8%的患者LDG水平较高。LDG活性高的未治疗患者骨外病灶的发生率为36.8%，中位生存期为19个月。LDG活性正常时，上述值分别为6.8%和超过36个月。LDG水平最高出现在终末期浆细胞白血病患者中。分泌IgD的MM患者的特点是LDG浓度升高更为频繁。107例活跃MM患者中有58例（54.2%）LDG含量正常。128例肌酐正常的患者中有75例β2-MG水平超过6mg/l。这些患者的中位生存期较短，为24个月。β2-MG水平低于6mg/l的患者在36个月的随访中未达到中位生存期。作者认为，β2-MG浓度在所有骨髓瘤分泌型和非分泌型骨髓瘤中均具有预后价值，尽管其指示并非绝对，因为14%的MM高活性患者β2-MG水平较低。给出了40例高危MM患者的比较结果。第1组（20例患者）接受了标准化化疗。第2组（20例患者）接受了强化多药化疗。第1组和第2组的中位生存期分别为12个月和26个月。
