难治复发性多发性骨髓瘤特点分析  

Analysis of clinical features of patients with relapsing or refractory multiple myeloma.

作　　者：陈大燕[1] 冯茹[1] 张钰[1] 魏永强[1] 黄芬[1] 刘晓力[1] 徐兵[1] 孟凡义[1] 

机构地区：[1]南方医科大学南方医院血液科,广州510515

出　　处：《广东医学》2011年第1期57-60,共4页Guangdong Medical Journal

摘　　要：目的探讨难治复发性多发性骨髓瘤(multiple myeloma,MM)患者临床特点及预后因素。方法回顾性分析初治并随访为难治复发的MM患者53例,对他们的临床表现及预后进行分析。并比较进展时间(time toprogression,TTP)<1年和≥1年两组患者预后。结果 53例难治复发的MM患者14例存活,25例死亡,14例失访。初诊时骨痛患者占79.2%,进展时为50.9%。临床Durie-salmon分期多为Ⅲ期,占84.9%。53例患者中10例合并髓外浆细胞侵犯,1例合并浆细胞白血病。53例患者中位进展时间为16.0个月,进展后中位随访时间为6.0个月,中位随访时间为29.5个月。21例患者进展时间<1年,32例≥1年。两组中位随访时间分别为11.0和44.0个月,进展后中位随访时间分别为4.0和12.0个月。结论 MM患者治疗过程中出现骨痛多提示疾病进展;骨髓浆细胞含量较高的患者预后较差;进展时间较早患者其进展后生存时间也相对较短。Objective To study the clinical features and prognostic factors of patients with relapsing or refractory multiple myeloma（MM）.Methods 53 previously untreated patients with MM,and diagnosed as refractory or relapsing MM with follow-up were included for retrospective analysis.Analysis was performed to evaluate the influence of known prognostic factors on prognosis between patients with TTP 〈1 year and ≥1 year.Results Of all the patients,25 patients followed up died,14 patients survived and 14 patients censored.Sacrodynia was the most common starting symptom（79.2%）,also in TTP（50.9%）.Patients with Durie-salmon Ⅲ stage accounted for 84.9%.There were 10 patients with extramedullary evolvemen and 1 patient with plasma cell leukemia.The median TTP,median follow-up time from progression and median follow-up time were 16.0,6.0 and 29.5 months,respectively.Patients with TTP1 year and ≥1 year accounted for 21 and 32 among all patients.The median follow-up time and follow-up time from progression were 11.0 months,44.0 months;and 4.0 months,12.0 months,respectively.Conclusion Sacrodynia may be a sign of the disease progression in the patients with MM.High plasma cell count in bone marrow and short time to progression are negative factors for prognosis.

关 键 词：多发性骨髓瘤 难治 多发性骨髓瘤 复发 临床表现 预后 进展 

分 类 号：R733.3[医药卫生—肿瘤]