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[多发性骨髓瘤——诊断、预后因素及治疗]

[Multiple myeloma--diagnosis, prognostic factors and treatment].

作者信息

Kitani T

机构信息

Osaka University Medical School.

出版信息

Rinsho Ketsueki. 1995 May;36(5):471-9.

PMID:7783353
Abstract

The problem of diagnosis, prognostic factors and the efficacy of therapies were investigated in 330 patients with multiple myeloma (MM) and 51 patients with benign monoclonal gammopathy (BMG)/monoclonal gammopathy of undetermined significance (MGUS). Seven out of 51 patients with BMG/MGUS were transformed into MM. The mean time to the transformation was 61.6 months. M protein level in these patients had been gradually and constantly increasing until the transformation in contrast with stable level in non-transformed patients. In MM there was one year difference between median survival from the time of diagnosis and start of chemotherapies. It depended on the deferral of treatment in patients with stage I myeloma. No difference of survival time was found between initial and differed therapy for stage I myeloma. Earlier therapy is not advantageous in this stage. Stages and immunoglobulin classes of MM were prognostic factors. Stage I or IgG myeloma had the longest survival and stage III or BJP myeloma had the shortest one. The new protocol, DMVM plus natural interferon alpha therapy induced high complete remission rate of 37.1% in initial treatment patients. The survival rate at three years from the treatment was 70%.

摘要

对330例多发性骨髓瘤(MM)患者和51例良性单克隆丙种球蛋白病(BMG)/意义未明的单克隆丙种球蛋白病(MGUS)患者的诊断问题、预后因素及治疗效果进行了研究。51例BMG/MGUS患者中有7例转化为MM。转化的平均时间为61.6个月。与未转化患者的稳定水平相比,这些患者的M蛋白水平在转化前一直在逐渐持续升高。在MM中,从诊断到开始化疗的中位生存期相差一年。这取决于I期骨髓瘤患者治疗的延迟。I期骨髓瘤初始治疗和延迟治疗的生存时间没有差异。在这个阶段,早期治疗并无优势。MM的分期和免疫球蛋白类别是预后因素。I期或IgG骨髓瘤的生存期最长,III期或BJP骨髓瘤的生存期最短。新方案DMVM加天然α干扰素治疗使初始治疗患者的完全缓解率高达37.1%。治疗三年后的生存率为70%。

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