A Retrospective Analysis: A Novel Index Predicts Survival and Risk-Stratification for Bone Destruction in 419 Newly Diagnosed Multiple Myelomas
A Retrospective Analysis: A Novel Index Predicts Survival and Risk-Stratification for Bone Destruction in 419 Newly Diagnosed Multiple Myelomas
复制标题
回顾性分析：一种新指数可预测 419 例新诊断的多发性骨髓瘤的生存率和骨破坏风险分层
DOI：
10.2147/ott.s229122
复制
发表时间：
2019-01-01
影响因子：
4
通讯作者：
Zhou, Fuling
中科院分区：
文献类型：
--
作者：
Jin, Yanxia;Shang, Yufeng;Zhou, Fuling
目的多发性骨髓瘤（MM）患者骨质破坏较难恢复，进一步探讨影响MM骨质破坏的因素具有重要的临床意义。方法与结果本研究回顾性分析了419例MM患者的临床资料，多元线性回归分析显示，血清Ca 2+浓度高、CD 138免疫表型阳性率高、细胞遗传学13 q34缺失的晚期MM患者更易发生骨质破坏，而总胆汁酸（TBA）和κ链同位素与MM患者骨破坏呈负相关。Kaplan-Meier分析显示，钙离子、血清β2-微球蛋白（β2-MG）、血红蛋白（HGB）、肌酐（CREA）、尿酸（UA）和年龄与MM患者骨破坏的生存率相关。考克斯回归分析进一步显示，β2-MG和CREA作为独立的预后因素，对骨质破坏患者的早期死亡风险更高。并根据β2-MG和球蛋白（GLB）与白色血细胞（WBC）比值计算一个预测骨质破坏患者生存不良的指标。结论骨髓瘤常规检查方法可替代骨髓穿刺检查，为骨髓瘤患者的预后判断提供新的指标，为临床评估提供参考。
Objective Multiple myeloma (MM) patients with bone destruction are difficult to restore, so it is of great clinical significance to further explore the factors affecting MM bone destruction. Methods and results This study retrospectively analyzed 419 cases with MM. Multiple linear regression analysis showed that those MM patients with a higher concentration of Ca2+ in serum, higher positive rate of CD138 immuno-phenotype and advanced in stage with 13q34 deletion in cytogenetics would be more prone to bone destruction, while total bile acid (TBA) and kappa chain isotope negatively correlated with bone destruction in MM patients. The Kaplan–Meier analysis indicated that Ca2+, serum β2-microglobulin (β2-MG), hemoglobin (HGB), creatinine (CREA), uric acid (UA) and age correlated with the survival of bone destruction in MM patients. Cox regression analysis further showed that the independent prognostic factors of β2-MG and CREA had a higher risk for early mortality in bone destruction patients. Moreover, an index was calculated based on β2-MG and globulin (GLB) to white blood cell (WBC) ratio to predict the poor survival of bone destruction patients. Conclusion We provide a novel marker to predict the prognosis of myeloma patients using routine examination method instead of bone marrow aspiration, and provide a reference for clinical evaluation.