Mayo MASS和R2-ISS分期系统在初诊多发性骨髓瘤患者中的预后价值验证:单中心研究  

Validation of the prognostic value of the Mayo MASS and R2-ISS staging systems in patients newly diagnosed with multiple myeloma:A single-center study

作　　者：徐影 沈旭星 金媛媛 李建勇[1] 陈丽娟[1] 张闰[1] Xu Ying;Shen Xuxing;Jin Yuanyuan;Li Jianyong;Chen Lijuan;Zhang Run(Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院血液科,南京210029

出　　处：《中华血液学杂志》2023年第9期749-754,共6页Chinese Journal of Hematology

基　　金：江苏省科技计划专项资金社会发展项目(BE2022810);国家自然科学基金(82070223);国家自然科学基金青年科学基金项目(82200223);江苏省青年自然科学基金(BK20220718)。

摘　　要：目的验证Mayo MASS、R2-ISS分期系统在初诊多发性骨髓瘤(MM)患者中的预后价值。方法纳入南京医科大学第一附属医院收治的371例初诊MM患者,胞质轻链免疫荧光结合荧光原位杂交(cIg-FISH)检测患者的细胞遗传学特征,结合患者的临床资料分析其疾病分期并评估预后。结果R-ISS分期Ⅰ、Ⅱ、Ⅲ期患者分别有37例(10.0%)、264例(71.2%)和70例(18.8%),中位无进展生存(PFS)时间分别为37、31和14个月(P=0.001),中位总生存(OS)时间分别为未达到(NR)、66个月和31个月(P<0.001)。Mayo MASS分期Ⅰ、Ⅱ、Ⅲ期患者分别有71例(19.1%)、140例(37.7%)和160例(43.2%),中位PFS时间分别为43、27和19个月(P<0.001),中位OS时间分别为NR、NR和35个月(P<0.001)。R2-ISS分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期患者分别有23例(6.2%)、69例(18.6%)、222例(59.8%)和57例(15.4%),中位PFS时间分别为47、31、25和15个月(P=0.001),中位OS时间分别为NR、NR、49个月和55个月(P<0.001)。结论Mayo MASS和R2-ISS分期系统在R-ISS分期基础上纳入了1q21+,分期更完善,但两种分期系统下Ⅲ期患者比例偏高,考虑与中国MM患者1q21+发生率和ISSⅢ期比例较高相关。Objective To evaluate the prognostic value of Mayo MASS and R2-ISS staging systems in patients newly diagnosed with multiple myeloma(MM).Methods A total of 371 patients newly diagnosed with MM in Jiangsu Province Hospital were included in the study.Cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization(cIg-FISH)was performed to detect cytogenetic abnormality.Clinical characteristics were combined to analyze the disease stage and evaluate the prognosis.Results There were 37(10.0%),264(71.0%),and 70(18.8%)patients in R-ISS stageⅠ,Ⅱ,andⅢ,respectively.The median progression-free survival(PFS)times were 37,25,and 14 months(P<0.001).The median overall survival(OS)times were not reached(NR),66,and 30 months(P<0.001).There were 71(19.1%),140(37.7%),and 160(43.2%)patients in Mayo MASS stagesⅠ,Ⅱ,andⅢ,and the median PFS times periods were 43,27,and 19 months(P<0.001),and the median OS times were NR,NR,35 months,respectively(P<0.001).There were,23(6.2%),69(18.6%),222(59.8%),and 57(15.4%)patients in R2-ISS stagesⅠ,Ⅱ,Ⅲ,andⅣ,respectively.The median PFS times were 47,31,25,and 15 months(P=0.001),and the median OS times were NR,NR,49,and 55 months,respectively(P<0.001).Conclusion Based on the R-ISS staging system,Mayo MASS,and R2-ISS prognostic staging system incorporated 1q21+,which allows a better stratification.However,the proportion of stageⅢpatients in Mayo MASS and R2-ISS staging systems is relatively high,which is considered related to the high incidence of 1q21+and ISSⅢin the Chinese population.

关 键 词：多发性骨髓瘤 Mayo分期系统 R2-ISS 预后 

分 类 号：R733.3[医药卫生—肿瘤]