文章：

沙定义多发性骨髓瘤的治愈：年轻骨髓瘤患者与可治愈血液系统恶性肿瘤患者结局的比较研究

Defining cure in multiple myeloma: a comparative study of outcomes of young individuals with myeloma and curable hematologic malignancies

原文发布日期：2018-02-28

DOI: 10.1038/s41408-018-0065-8

类型: Article

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英文摘要：

Advances in therapy in recent years have led investigators to challenge the dogma that multiple myeloma (MM) is incurable. We assessed overall (OS) and progression-free survival (PFS) of young patients ( ≤ 50 years) with MM and compared outcomes with follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), and Hodgkin lymphoma (HL). All patients ≤ 50 years with newly diagnosed MM (n = 212), FL (n = 168), DLBCL (n = 195), and HL (n = 233) between 1 January 2005 and 31 December 2015 were included. Observed vs. expected survival was summarized by standardized mortality ratios (SMR). Compared to the background US population, excess mortality risk was seen at diagnosis in all four cancers, SMR 19.5 (15.2–24.5) in MM, 4.2 (2.3–7.2) in FL, 13.0 (9.2–18.4) in DLBCL, and 5.2 (2.6–9.3) in HL. We reasoned that cure would most likely occur in the first 3 years after diagnosis and be reflected by an overall survival probability similar to the background population. From the 36-month landmark, excess mortality risk was seen in MM (SMR 20.7 [14.7–28.3]) and FL (SMR 3.8 [1.5–7.8]), but not with DLBCL (SMR 3.1 [0.8–8.0]) or HL (SMR 0.9 [0.0–5.1]). MM patients have 20-fold excess mortality risk compared to the background population at diagnosis and at 3 years after diagnosis, suggesting that MM remains an incurable cancer.

摘要翻译： 

近年来治疗方法的进展使研究者开始挑战多发性骨髓瘤(MM)不可治愈的传统观点。我们评估了年轻患者(≤50岁)MM的总生存期(OS)和无进展生存期(PFS)，并与滤泡性淋巴瘤(FL)、弥漫大B细胞淋巴瘤(DLBCL)及霍奇金淋巴瘤(HL)的结局进行比较。研究纳入2005年1月1日至2015年12月31日期间所有≤50岁新确诊患者：MM 212例、FL 168例、DLBCL 195例、HL 233例。通过标准化死亡比(SMR)总结观察生存期与预期生存期。与美国总体人群相比，四种癌症在诊断时均存在超额死亡风险：MM的SMR为19.5(15.2-24.5)，FL为4.2(2.3-7.2)，DLBCL为13.0(9.2-18.4)，HL为5.2(2.6-9.3)。我们推断治愈最可能发生在诊断后前3年，并表现为总生存概率与背景人群相似。从36个月界标分析点观察，MM(SMR 20.7[14.7-28.3])和FL(SMR 3.8[1.5-7.8])仍存在超额死亡风险，而DLBCL(SMR 3.1[0.8-8.0])和HL(SMR 0.9[0.0-5.1])则未显现。MM患者在诊断时及诊断后3年的超额死亡风险达到背景人群的20倍，这表明MM仍是一种不可治愈的恶性肿瘤。

原文链接：

Defining cure in multiple myeloma: a comparative study of outcomes of young individuals with myeloma and curable hematologic malignancies