Ong F, Hermans J, Noordijk E M, Wijermans P W, Kluin-Nelemans J C
Comprehensive Cancer Center West, Leiden, The Netherlands.
Ann Hematol. 1995 Mar;70(3):149-52. doi: 10.1007/BF01682035.
We studied the medical histories of 127 patients diagnosed with multiple myeloma included in a population-based registry of 945 patients with a para-protein or multiple myeloma in the region of the Comprehensive Cancer Center West (CCCW). We defined patients "not immediately diagnosed" or "delayed diagnosis" as those patients in whom myeloma was not included in the initial differential diagnosis. We found that 37% belonged to this category. These patients more often had symptoms not associated with multiple myeloma. Since a surprising 51% of patients with delayed diagnosis turned out to have stage-III myeloma, the physician should be alert to the presence of this disease, despite the fact that co-morbidity may mask its presence.
我们研究了127例被诊断为多发性骨髓瘤患者的病史，这些患者纳入了西部综合癌症中心（CCCW）地区945例副蛋白血症或多发性骨髓瘤患者的基于人群的登记系统。我们将“未立即诊断”或“延迟诊断”的患者定义为那些骨髓瘤未被纳入初始鉴别诊断的患者。我们发现37%的患者属于这一类别。这些患者更常出现与多发性骨髓瘤无关的症状。由于令人惊讶的是，51%延迟诊断的患者最终被诊断为III期骨髓瘤，因此医生应警惕这种疾病的存在，尽管合并症可能掩盖其存在。
