HALP评分作为初诊多发性骨髓瘤预后标志指标的意义  

Significance of HALP Score as a Prognostic Indicator for Newly Diagnosed Multiple Myeloma

作　　者：张宽顺 吕殿亮[1] 石琳[1] ZHANG Kuan-Shun;LYU Dian-Liang;SHI Lin(Department of Hematology,Henan Provincial Hospital of Traditional Chinese Medicine,Zhengzhou 450001,Henan Province,China)

机构地区：[1]河南省中医院血液科,河南郑州450001

出　　处：《中国实验血液学杂志》2025年第2期442-446,共5页Journal of Experimental Hematology

摘　　要：目的:探讨HALP评分作为初诊多发性骨髓瘤(MM)预后标志指标的意义。方法:收集并回顾性分析2020年1月至2022年12月在河南省中医院就诊的62例初诊MM患者的临床资料,分析低HALP评分组与高HALP评分组患者之间年龄、性别、DS分期、R-ISS分期、M蛋白类型、肌酐(Scr)、β_(2)-MG、血钙、乳酸脱氢酶(LDH)、血红蛋白(Hb)、白蛋白(ALB)、血小板计数(PLT)、淋巴细胞计数(ALC)的差异。单因素和多因素分析上述指标对初诊MM患者的预后价值。结果:经X-tile软件确定HALP评分的最佳截断值为41,据此将62例患者分为高HALP组(HALP>41,n=25)和低HALP组(HALP≤41,n=37)。高HALP组Hb≥100 g/L患者的占比明显高于低HALP组(P<0.05)。高HALP组与低HALP组患者的中位总生存期(OS)分别为29(9-39)个月和20(4-29)个月,组间差异有统计学意义(P<0.01)。单因素分析结果显示,R-ISS分期、ALB、Hb、ALC、HALP与患者的预后密切相关(P<0.05)。COX回归多因素分析结果显示,R-ISS分期Ⅲ期(HR=4.443,95%CI:1.480-13.343,P=0.008)、HALP≤41(HR=8.823,95%CI:1.858-41.910,P=0.006)是初诊多发性骨髓瘤患者生存期缩短的独立危险因素。在R-ISS分期Ⅲ期中,高HALP组患者的中位OS明显高于低HALP组患者,差异有统计学意义(P<0.05)。结论:HALP评分可作为初诊MM患者的预后标志指标。Objective:To investigate the significance of HALP score as a prognostic indicator for newly diagnosed multiple myeloma(MM).Methods:Clinical data of 62 newly diagnosed MM patients in our hospital from January 2020 to December 2022 were collected and retrospectively analyzed.The difference in age,sex,DS stage,R-ISS stage,M protein type,serum creatinine(Scr),β_(2)-microglobulin(β_(2)-MG),blood calcium,lactate dehydrogenase(LDH),hemoglobin(Hb),albumin(ALB),platelet count(PLT),and absolute lymphocyte count(ALC)between patients with low and high HALP scores were analyzed.The prognostic value of the above indexes in newly diagnosed MM patients was analyzed by univariate and multivariate analysis.Results:The optimal cut-off value of HALP score was 41 determined by X-tile software.Based on this,62 patients were divided into a high HALP group(HALP>41,n=25)and a low HALP group(HALP≤41,n=37).The proportion of patients with Hb≥100 g/L in the high HALP group was significantly higher than that in the low HALP group(P<0.05).The median overall survival(OS)time of patients in the high HALP group and low HALP group were 29(9-39)months and 20(4-29)months,respectively,with statistically significant difference between the two groups(P<0.01).Univariate analysis showed that R-ISS stage,ALB,Hb,ALC and HALP were closely related to the prognosis of patients(P<0.05).COX regression multivariate analysis showed that R-ISS stageⅢ(HR=4.443,95%CI:1.480-13.343,P=0.008)and HALP≤41(HR=8.823,95%CI:1.858-41.910,P=0.006)were independent risk factors for shortened OS in newly diagnosed MM patients.The median OS of patients with high HALP at R-ISS stageⅢwas significantly higher than that of patients with low HALP at the same stage,and the difference was statistically significant(P<0.05).Conclusion:HALP score can be used as a prognostic indicator for newly diagnosed MM patients.

关 键 词：HALP评分 多发性骨髓瘤 预后 R-ISS分期 

分 类 号：R733.3[医药卫生—肿瘤]