多发性骨髓瘤6q缺失患者的临床特征研究  

Clinical characteristics of patients with multiple myeloma harboring 6q deletion

作　　者：陈蕾[1] 孙春艳[1] 安博文 余建明 赵菲 张纯[1] 胡豫[1] Chen Lei;Sun Chunyan;An Bowen;Yu Jianming;Zhao Fei;Zhang Chun;Hu Yu(Institute of Hematology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Hematology,Xinyang Central Hospital,Xinyang 464000,China)

机构地区：[1]华中科技大学同济医学院附属协和医院血液病研究所,武汉430022 [2]信阳市中心医院血液内科,信阳464000

出　　处：《中华血液学杂志》2021年第8期642-645,共4页Chinese Journal of Hematology

基　　金：国家自然科学基金(81974007、81670197)。

摘　　要：目的研究多发性骨髓瘤6q缺失患者的临床特征、细胞遗传学特点,分析6q缺失对患者生存的影响。方法回顾性分析华中科技大学同济医学院附属协和医院2014-2017年新诊断的382例多发性骨髓瘤患者,比较6q缺失患者与非6q缺失患者的临床特征及细胞遗传学特点。并采用Log-rank检验及Cox比例风险回归模型分析影响患者无进展生存(PFS)期和总生存(OS)期的预后因素。结果6q缺失患者与非6q缺失患者比较,中位年龄较高(63岁对58岁,P=0.039),t(4;14)发生率较高(30.4%对16.4%,P=0.020),并伴有更高比例的复杂核型(22.2%对5.3%,P=0.001)。Log-rank单因素生存分析显示,6q缺失与较短的PFS期相关。但在Cox多因素比例风险回归模型中,6q缺失不是独立的预后因素,其对生存期的影响受到年龄、t(4;14)等其他危险因素的影响。结论多发性骨髓瘤中6q缺失多见于高龄患者,常伴随t(4;14)及复杂核型,但6q缺失不是独立预后因素。Objective To study the clinical and cytogenetic characteristics of patients with multiple myeloma harboring 6q deletion,with the aim to determine the impact of 6q deletion on survival.Methods This study included the retrospective analysis of 382 newly diagnosed patients with multiple myeloma in our hospital from 2014 to 2017 and compared the clinical and cytogenetic characteristics between patients with and without 6q deletion.The log-rank test and the Cox proportional hazards regression model were used to analyze prognostic factors for progression-free survival(PFS)and overall survival(OS).Results Compared to those without 6q,the patients with 6q deletion were older(median age,63 vs 58 years,P=0.039),had higher incidence of t(4;14)(30.4%vs 16.4%,P=0.020),and higher proportion of complex karyotypes(22.2%vs 5.3%,P=0.001).Univariate survival analysis using the log-rank test revealed that 6q deletion was associated with shorter PFS.However,by the Cox multivariate proportional hazards regression model,6q deletion was not an independent prognostic factor and its effect on survival was affected by age,t(4;14),and other risk factors.Conclusions 6q deletion was common in elderly patients with multiple myeloma and was often accompanied by t(4;14)and complex karyotypes.However,6q deletion was not an independent prognostic factor for multiple myeloma.

关 键 词：多发性骨髓瘤 细胞遗传学 6q缺失 预后 

分 类 号：R733.3[医药卫生—肿瘤]