多发性骨髓瘤患者化学治疗后获得快速完全缓解与生存率的关系  

The correlation between rapid complete remission after chemotherapy and survival rate in the patients with multiple myeloma

作　　者：马晶晶[1] 邓媛[1] 陈月[1] 史玉叶[1] 张欣[1] 张权娥 何正梅[1] 于亮[1] MA Jingjing;DENG Yuan;CHEN Yue(Department of Hematology,Affiliated Huai'an First Hospital,Nanjing Medical University,Huai'an 223300,CHINA)

机构地区：[1]南京医科大学附属淮安第一医院血液科,江苏淮安223300

出　　处：《江苏医药》2024年第1期29-33,共5页Jiangsu Medical Journal

基　　金：江苏省卫生健康委员会科研课题(H2018085);淮安市卫生健康科研立项项目(HAWJ202109);徐州医科大学附属医院发展基金项目(XYFM2021036)。

摘　　要：目的 分析多发性骨髓瘤(MM)患者化学治疗(化疗)后获得快速完全缓解(CR)与生存率的关系。方法 回顾性分析接受≥4个疗程以硼替佐米为基础化疗方案治疗的55例首次达CR的初诊MM患者临床资料;其中,A组24例患者获得快速CR(经2个疗程化疗达CR),B组31例患者未获得快速CR(经>2个疗程化疗达CR)。绘制Kaplan-Meier生存曲线,比较两组患者无进展生存率及总生存率。多因素Cox回归分析患者出现疾病进展的独立影响因素。结果 A、B组患者中位随访时间分别为16.2、22.9个月。55例患者中,9例(16.4%)死亡,11例(20.0%)出现疾病进展。Kaplan-Meier生存曲线分析结果显示,A组患者无进展生存率低于B组患者(P<0.05),有遗传学高危因素患者无进展生存率低于无遗传学高危因素患者(P<0.05)。多因素Cox回归分析显示,有遗传学高危因素和获得快速CR是患者出现疾病进展的独立危险因素(P<0.05)。结论 有遗传学高危因素和以硼替佐米为基础化疗方案治疗后获得快速CR的MM患者无进展生存期较短。Objective To analyze the correlation between rapid complete remission(CR) after chemotherapy and survival rate in the patients with multiple myeloma(MM).Methods The clinical data of 55 newly diagnosed MM patients received≥4 courses of chemotherapy based on bortezomib and achieved CR for the first time were retrospectively analyzed.Among them, 24 patients in group A had rapid CR(achieved CR after 2 courses of chemotherapy),while 31 patients in group B had no rapid CR(achieved CR after>2 courses of chemotherapy).The progression free survival rate and overall survival rate of the two groups were compared by Kaplan-Meier survival curve.Multivariate Cox regression analysis was used to analyze the independent influencing factors for disease progression.Results The median follow-up time for groups of A and B was 16.2 and 22.9 months, respectively.Among 55 patients, 9 patients(16.4%) died and 11 patients(20.0%) experienced disease progression.Kaplan-Meier survival curve analysis showed that the progression free survival rate of the patients in group A was lower than that of the patients in group B(P<0.05),which of the patients with genetic high-risk factors was lower than that of the patients without genetic high-risk factors(P<0.05).The results of multivariate Cox regression analysis showed that having genetic high-risk factors and obtaining rapid CR were the independent risk factors for disease progression in MM patients(P<0.05).Conclusion The MM patients with genetic high-risk factors and rapid CR have a shorter progression free survival period after the chemotherapy based on bortezomib.

关 键 词：多发性骨髓瘤 硼替佐米 遗传学高危 无进展生存 

分 类 号：R551[医药卫生—血液循环系统疾病]