Paule B
Service de Rhumatologie, Hôpital de Bicêtre, Le Kremlin Bicêtre.
Ann Med Interne (Paris). 1997;148(8):534-41.
Multiple myeloma is a heterogeneous disease with survival ranging from a few months to many years. Several clinical parameters (S beta 2-M) are a direct expression of the tumor burden and have been shown by univariate analysis to be related to patient survival. Durie and Salmon developed a myeloma staging system that analyzed the presenting clinical features, response to treatment and survival duration. But this classification is not related to the intrinsic malignancy (labeling index). Many new parameters (genetic alterations, plasma cell evaluation; serum marqueurs, immune dysregulation) related to patient response to chemotherapy and survival duration have been identified. However, they have not yet been included in standard staging and compared with the recognized prognostic parameters in multivariate analysis. There is a need to create a new international myeloma staging system based on biological features of the disease.
多发性骨髓瘤是一种异质性疾病，生存期从数月到数年不等。几个临床参数（血清β2-微球蛋白）是肿瘤负荷的直接表现，单因素分析表明其与患者生存期相关。Durie和Salmon开发了一种骨髓瘤分期系统，该系统分析了患者的临床特征、治疗反应和生存时间。但这种分类与内在恶性程度（标记指数）无关。许多与患者化疗反应和生存时间相关的新参数（基因改变、浆细胞评估、血清标志物、免疫失调）已被确定。然而，它们尚未被纳入标准分期，也未在多因素分析中与公认的预后参数进行比较。有必要基于该疾病的生物学特征创建一个新的国际骨髓瘤分期系统。
