Callaway M W, Braud E L, McDonald C R, Paine C J, Eichner E R
South Med J. 1977 Feb;70(2):138-41, 152. doi: 10.1097/00007611-197702000-00004.
In light of the variable clinical expression and bone marrow plasmacytosis of multiple myeloma, we studied prospectively the prevalence and clinical correlates of bone marrow plasmacytosis in 133 anemic medical inpatients. Seventeen patients (13%) had 5% or more, and four patients (3%) had 10% or more marrow plasma cells. Only two patients (with plasmacytosis of 7.4% and 46.2%, respectively) had multiple myeloma. Lung infections (pneumonia, tuberculosis, abscess) accounted for 41% of the cases of plasmacytosis. We found that plasmacytosis correlated with the severity of pneumonia and that active pulmonary tuberculosis was usually associated with notable plasmac. ytosis. Cancer and liver disease were not important causes of plasmacytosis in this study. There was a correlation between plasmacytosis and serum hyperglobulinemia. A correlation between advancing age of the patients and increasing prevalence of plasmacytosis was attributed in part to an increasing prevalence of serious illness with age. However, some elderly patients with apparently benign disorders had unexplained plasmacytosis.
鉴于多发性骨髓瘤临床表现多样且存在骨髓浆细胞增多,我们对133例贫血内科住院患者的骨髓浆细胞增多症的患病率及其临床相关因素进行了前瞻性研究。17例患者(13%)骨髓浆细胞比例达到或超过5%,4例患者(3%)骨髓浆细胞比例达到或超过10%。仅有2例患者(骨髓浆细胞比例分别为7.4%和46.2%)患有多发性骨髓瘤。肺部感染(肺炎、肺结核、脓肿)占骨髓浆细胞增多症病例的41%。我们发现骨髓浆细胞增多与肺炎严重程度相关,活动性肺结核通常伴有显著的骨髓浆细胞增多。在本研究中,癌症和肝脏疾病并非骨髓浆细胞增多的重要原因。骨髓浆细胞增多与血清球蛋白血症相关。患者年龄增长与骨髓浆细胞增多患病率增加之间的相关性部分归因于随着年龄增长严重疾病患病率增加。然而,一些患有明显良性疾病的老年患者存在无法解释的骨髓浆细胞增多。