基于化疗前外周血的HALP评分对多发性骨髓瘤的预后相关性分析  

Prognostic correlation analysis of multiple myeloma based on HALP score of peripheral blood before chemotherapy

作　　者：陈敏[1] 安礼影 林晓静[1] 赵攀[1] 邹兴立[1] 魏锦[1] 倪勋[1] CHEN Min;AN Liying;LIN Xiaojing;ZHAO Pan;ZOU Xingli;WEI Jin;NI Xun(Department of Hematology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]川北医学院附属医院血液内科,四川南充637000

出　　处：《中国输血杂志》2025年第1期61-67,72,共8页Chinese Journal of Blood Transfusion

摘　　要：目的探讨多发性骨髓瘤(multiple myeloma,MM)患者HALP评分对MM预后的预测价值。方法回顾性分析川北医学院附属医院自2016年1月至2023年10月收治的初治多发性骨髓瘤(newly diagnosed multiple myeloma,NDMM)患者首次治疗前的实验室指标及其相关临床资料,并计算HALP评分,采用X-tile软件计算HALP最佳截断值,并采用Kaplan-Meier曲线对高HALP组及低HALP组进行生存分析,通过Cox回归模型进行单因素及多因素分析,并使用Graphpad Prism绘制可能影响患者预后因素的森林图。采用受试者工作曲线(receiver operating characteristic curve,ROC)评估HALP评分及其联合β2-微球蛋白及ECOG评分对MM患者预后的预测能力。结果共纳入203例MM患者,HALP评分的最佳截断值为29.15(P<0.05),其中低HALP评分组101例,高HALP评分组102例。Cox回归模型单变量和多变量分析结果显示HALP评分<29.15是无进展生存时间(progression-free survival,PFS)及总生存期(overall survival,OS)的独立危险因素(P<0.05)。ROC曲线结果提示,HALP联合β2-微球蛋白及ECOG评分在预测MM患者预后比单独使用HALP评分具有更高的预测价值。结论HALP评分与NDMM患者的预后密切相关。低HALP评分提示患者预后较差,而HALP评分联合β2-微球蛋白及ECOG评分在联合评估时预测价值更高。Objective To explore the predictive value of HALP score for prognosis in patients with multiple myeloma(MM).Methods A retrospective analysis was conducted on laboratory indicators and related clinical data of newly diagnosed multiple myeloma(NDMM)patients,treated at the Affiliated Hospital of North Sichuan Medical College from January 2016 to October 2023,prior to their first treatment.The HALP score was calculated,and the optimal cutoff value for HALP was determined using X-tile software.Survival analysis was performed using Kaplan-Meier curves for high HALP and low HALP groups.Univariate and multivariate analyses were conducted using the Cox regression model,and a forest plot was generated using Graphpad Prism to illustrate factors that may impact patient prognosis.The predictive ability of HALP score combined withβ2-microglobulin and ECOG score for prognosis in MM patients was evaluated using receiver operating characteristic curve(ROC)analysis.Results A total of 203 MM patients were included,with the optimal cutoff value for HALP score being 29.15(P<0.05).Among them,101 patients were in the low HALP score group,and 102 patients were in the high HALP score group.The results of univariate and multivariate analysis using the Cox regression model showed that a HALP score<29.15 was an independent risk factor for progression-free survival(PFS)and overall survival(OS)(P<0.05).ROC curve analysis indicated that the combination of HALP score withβ2-microglobulin and ECOG score had a higher predictive value for prognosis in MM patients compared to using HALP score alone.Conclusion The HALP score is closely related to the prognosis of patients with NDMM.A low HALP score indicates a poorer prognosis,while the combination of HALP score withβ2-microglobulin and ECOG score provides a higher predictive value when assessed together.

关 键 词：多发性骨髓瘤 预后 血红蛋白 淋巴细胞 白蛋白 血小板 

分 类 号：R457.1[医药卫生—治疗学]