文章：

中国初诊多发性骨髓瘤患者的临床特征与治疗结局：多中心分析结果

Clinical features and treatment outcome in newly diagnosed Chinese patients with multiple myeloma: results of a multicenter analysis

原文发布日期：2014-08-15

DOI: 10.1038/bcj.2014.55

类型: Original Article

开放获取: 是

英文摘要：

The aim of this study was to understand the clinical features and treatment outcome of Chinese patients with multiple myeloma (MM). This retrospective study enrolled 940 newly diagnosed inpatients (median age, 59 years; immunoglobulin (Ig)D isotype, 6.5%) with complete follow-up data at three centers. In all, 85.8% of patients were of Durie-Salmon stage III and 48.3% were of International Staging System (ISS) stage III at diagnosis. Also, 9.6% of patients had extramedullary plasmacytoma. Compared with IgG, IgD-type patients were diagnosed at a younger age, and more patients were of ISS stage III, with hypercalcemia, elevated levels of lactate dehydrogenase, hyperuricemia, renal dysfunction and 1q21 amplification (P=0.03). The overall survival (OS) benefit was more prominent in IgG than in IgD when patients received bortezomib; however, they showed no significant difference when they received older therapies such as melphalan combined with prednisone or vincristine combined with adriamycin and dexamethasone. Fluorescence in situ hybridization (FISH) results showed that 17.6% had 17p13 deletion. Conventional cytogenetics revealed that 13.3% were hypodiploid and those cases had the worst survival, but hyperdiploid cases (9.3%) did not show any survival benefit compared with those with a normal karyotype (77.4%). Median OS and progression-free survival for all patients were 54 and 26 months, respectively. Significant factors for survival by multivariate analysis were gender, ISS stage, number of FISH abnormalities and extramedullary disease. MM in mainland China presents with different features, with patients being of younger age and having higher risk and more survival benefit in IgG patients receiving bortezomib.

摘要翻译： 

本研究旨在探讨中国多发性骨髓瘤（MM）患者的临床特征及治疗结局。这项回顾性研究纳入了三家中心的940例新确诊住院患者（中位年龄59岁；免疫球蛋白D亚型占比6.5%），均具有完整随访资料。总体患者中85.8%处于Durie-Salmon分期III期，48.3%在确诊时属于国际分期系统（ISS）III期。此外，9.6%的患者存在髓外浆细胞瘤。与IgG型相比，IgD型患者确诊年龄更轻，且更多表现为ISS III期、高钙血症、乳酸脱氢酶升高、高尿酸血症、肾功能不全及1q21扩增（P=0.03）。接受硼替佐米治疗时，IgG型患者的总生存期优势较IgD型更显著；而使用传统方案（如马法兰联合泼尼松，或长春新碱联合阿霉素和地塞米松）时两者无显著差异。荧光原位杂交（FISH）检测显示17.6%患者存在17p13缺失，常规细胞遗传学发现13.3%为亚二倍体且预后最差，但超二倍体（9.3%）与正常核型（77.4%）患者相比未显示生存获益。全体患者中位总生存期和无进展生存期分别为54个月和26个月。多因素分析显示性别、ISS分期、FISH异常数量及髓外病变是显著生存影响因素。中国大陆MM患者呈现独特特征：发病年龄更轻、危险度更高，且IgG型患者接受硼替佐米治疗生存获益更显著。

原文链接：

Clinical features and treatment outcome in newly diagnosed Chinese patients with multiple myeloma: results of a multicenter analysis