多发性骨髓瘤继发骨髓纤维化的骨髓病理学特征及与疾病预后的关系  

Pathological Characteristics of Bone Marrow in Multiple Myeloma Patients with Secondary Myelofibrosis and Their Relationship with Prognosis

作　　者：赵娟[1] 马乐[1] 关键虹[1] 

机构地区：[1]西安交通大学第一附属医院血液内科,陕西西安710061

出　　处：《中国实验血液学杂志》2017年第4期1080-1085,共6页Journal of Experimental Hematology

摘　　要：目的:探讨多发性骨髓瘤继发骨髓纤维化的骨髓活检病理特征及其与疾病预后的关系。方法:回顾性分析2012年1月1日至12月31日期间本院血液内科收治的70例(其中35例患者继发骨髓纤维化)多发性骨髓瘤患者临床资料。观察患者骨髓活检病理学特征,对比分析骨髓涂片及活检增生程度、治疗后纤维化程度的变化,同时比较继发骨髓纤维化与未发生骨髓纤维化患者之间总死亡率的差异。结果:各期、各分型多发性骨髓瘤均可继发骨髓纤维化,骨髓纤维化可致骨髓涂片出现假性增生减低,继发骨髓纤维化患者骨髓纤维组织不同程度增生,Gomori染色阳性(+)至强阳性(+++),部分患者疾病好转后骨髓纤维化程度可减轻。结论:多发性骨髓瘤继发骨髓纤维化时骨髓活检对诊断有重要价值,继发骨髓纤维化患者较未发生纤维化患者总体预后欠佳。Objective： To investigate the pathological characteristics of bone marrow in multiple myeloma patients with secondary myelofibrosis and their relationship with prognosis. Methods： Clinical data of 70 cases of multiple myeloma including 35 patients with secondary myelofibrosis were analyzed retrospectively from January 1st to December 31 st 2012 in Department of Hematology of our hospital,the degree of hyperplasia,as well as the changes of myelofibros after treatment were compared between bone marrow smear and biopsy,and their relationship with the prognosis was analysed. Results： The myelofibrosis could be observed in any stage and type of multiple myeloma,the myelobibrosis could cause the decrease of pseudoepitheliomatous hyperplasia in bone marrow smear,and the increase of reticulin could be observed in the biopsy with Gomori staining ＋— ＋ ＋ ＋,and the secondary myelofibrosis could be alleviated after treatment. The overall prognosis of these patients was poor. Conclusion： The bone marrow biopsy has the important diagnostic value for the multiple myeloma patients with secondary myelofibrosis,and the myelofibrosis can be alleviated after treatment,but the overall prognosis of multiple myeloma patients with secondary myelofibrosis is poor.

关 键 词：多发性骨髓瘤 骨髓纤维化 骨髓涂片 骨髓活检 疾病预后 

分 类 号：R733.3[医药卫生—肿瘤] R551.3[医药卫生—临床医学]