IgD型多发性骨髓瘤患者的临床特征及预后分析  

Clinical Characteristics and Prognosis of Patients with IgD Multiple Myeloma

作　　者：张永前 赵继胜 魏小芳 冯友繁[2] 伏媛[2] 陈巧琳 张启科[2] ZHANG Yong-Qian;ZHAO Ji-Sheng;WEI Xiao-Fang;FENG You-Fan;FU Yuan;CHEN Qiao-Lin;ZHANG Qi-Ke(Department of Hematology,Qingyang People's Hospital,Qingyang 745000,Gansu Province,China;Department of Hematology,Gansu Provincial Hospital,Lanzhou 730000,Gansu Province,China)

机构地区：[1]庆阳市人民医院血液科,甘肃庆阳745000 [2]甘肃省人民医院血液科,甘肃兰州730000

出　　处：《中国实验血液学杂志》2025年第2期437-441,共5页Journal of Experimental Hematology

摘　　要：目的:探讨IgD型多发性骨髓瘤的临床特点及其预后。方法:收集2013年9月至2023年2月甘肃省人民医院收治的8例IgD型多发性骨髓瘤患者的临床资料,并对其临床特点及预后进行回顾性分析和总结。结果:8例患者中,男性4例,女性4例,中位发病年龄为60(44-74)岁;所有患者均有肾功能不全、贫血症状,骨侵犯3例,脾肿大3例,IgD-λ型7例,IgD-κ型1例。7例行FISH检查,6例1q21阳性。DS分期Ⅲ期6例,Ⅱ期2例;ISS分期Ⅲ期6例,Ⅱ期1例,Ⅰ期1例;R-ISS分期Ⅲ期5例,Ⅱ期3例。所有患者均接受硼替佐米为基础的联合化疗,其中1例行自体造血干细胞移植,2例联合达雷妥尤单抗。中位治疗6(1-15)个周期,4-6周期后评估近期疗效,在可评估疗效的6例患者中,1例PD,5例CR。中位随访26(11-33)个月,患者的中位PFS为11.25(3-26)个月,中位OS为18.5(4-33)个月。8例患者中,4例患者死亡。死亡患者中,3例R-ISS分期Ⅲ期,3例1q21阳性;5例早期达CR的患者中2例疾病进展死亡。结论:IgD型多发性骨髓瘤发病率低,早期肾脏损害、血液系统损害、骨侵蚀症状明显,中位生存期短,自体造血干细胞移植和/或达雷妥尤单抗可能会给患者带来持久缓解,但仍需大规模临床研究。Objective:To investigate the clinical characteristics and prognosis of patients with IgD multiple myeloma(MM).Methods:The clinical data of 8 patients with IgD MM admitted to Gansu Provincial Hospital from September 2013 to February 2023 were collected,and their clinical characteristics and prognosis were retrospectively analyzed and summarized.Results:Among the 8 enrolled patients,there were 4 males and 4 females,with a median age of 60(44-74)years.All patients had symptoms of renal insufficiency and anemia.There were 3 cases of bone invasion,3 cases of splenomegaly,7 cases of IgD-λtype,and 1 case of IgD-κtype.FISH examination was performed in 7 cases,and 6 of them were positive for 1q21.There were 6 cases in DS stage III and 2 cases in DS stage II;According to ISS staging,there were 6 cases in stage III,1 case in stage II,and 1 case in stage I;According to R-ISS staging,there were 5 cases in stage III and 3 cases in stage II.All patients received bortezomib-based combination chemotherapy,with 1 case undergoing autologous stem cell transplantation(ASCT)and 2 cases receiving daratumumab in combination.The median treatment period was 6(1-15)cycles.The short-term efficacy was evaluated after 4-6 courses of treatment.Among the 6 patients with assessable efficacy,1 case experienced disease progression(PD),and 5 cases achieved complete remission(CR).The median follow-up time was 26(11-33)months,and the median progression-free survival(PFS)and median overall survival(OS)of the patients were 11.25(3-26)months and 18.5(4-33)months,respectively.Among the 8 patients,4 cases died.Among the deceased patients,3 cases were in R-ISS stage III and 3 cases were 1q21 positive.2 of the 5 patients with early CR died due to disease progression.Conclusion:The incidence of IgD MM is low,the symptoms of early renal damage,blood system damage and bone erosion in IgD MM patients are obvious,and the median survival time is short.ASCT and/or daratumumab may bring lasting relief for IgD MM patients,but large-scale clinical studies are still

关 键 词：IGD型多发性骨髓瘤 IgD-λ IgD-κ 临床特征 预后 

分 类 号：R733.3[医药卫生—肿瘤]