文章：

冒烟型多发性骨髓瘤中疾病生物标志物的演变与早期进展风险

Evolving changes in disease biomarkers and risk of early progression in smoldering multiple myeloma

原文发布日期：2016-07-29

DOI: 10.1038/bcj.2016.65

类型: Original Article

开放获取: 是

英文摘要：

We studied 190 patients with smoldering multiple myeloma (SMM) at our institution between 1973 and 2014. Evolving change in monoclonal protein level (eMP) was defined as ⩾10% increase in serum monoclonal protein (M) and/or immunoglobulin (Ig) (M/Ig) within the first 6 months of diagnosis (only if M-protein ⩾3 g/dl) and/or ⩾25% increase in M/Ig within the first 12 months, with a minimum required increase of 0.5 g/dl in M-protein and/or 500 mg/dl in Ig. Evolving change in hemoglobin (eHb) was defined as ⩾0.5 g/dl decrease within 12 months of diagnosis. A total of 134 patients (70.5%) progressed to MM over a median follow-up of 10.4 years. On multivariable analysis adjusting for factors known to predict for progression to MM, bone marrow plasma cells ⩾20% (odds ratio (OR)=3.37 (1.30–8.77), P=0.013), eMP (OR=8.20 (3.19–21.05), P<0.001) and eHb (OR=5.86 (2.12–16.21), P=0.001) were independent predictors of progression within 2 years of SMM diagnosis. A risk model comprising these variables was constructed, with median time to progression of 12.3, 5.1, 2.0 and 1.0 years among patients with 0–3 risk factors respectively. The 2-year progression risk was 81.5% in individuals who demonstrated both eMP and eHb, and 90.5% in those with all three risk factors.

摘要翻译： 

我们研究了1973年至2014年间在本机构就诊的190例冒烟型多发性骨髓瘤患者。单克隆蛋白水平动态变化定义为：诊断后前6个月内血清单克隆蛋白和/或免疫球蛋白增幅≥10%（仅适用于M蛋白≥3g/dl的情况）和/或前12个月内增幅≥25%，且要求M蛋白最低增幅达0.5g/dl和/或免疫球蛋白最低增幅达500mg/dl。血红蛋白动态变化定义为诊断后12个月内下降≥0.5g/dl。中位随访10.4年期间，共有134例患者转化为多发性骨髓瘤。经多变量分析校正已知预测因素后，骨髓浆细胞≥20%、单克隆蛋白水平动态变化和血红蛋白动态变化被确认为SMM诊断后2年内疾病进展的独立预测因子。基于这些变量构建的风险模型显示，具有0-3个危险因素的患者中位进展时间分别为12.3年、5.1年、2.0年和1.0年。同时存在单克隆蛋白和血红蛋白动态变化的患者2年进展风险达81.5%，而具备全部三个危险因素的患者2年进展风险高达90.5%。

原文链接：

Evolving changes in disease biomarkers and risk of early progression in smoldering multiple myeloma