Staging multiple myeloma patients with active disease using serum levels of β2m-free HLA class I heavy chain together with IgM or platelet count
Staging multiple myeloma patients with active disease using serum levels of β2m-free HLA class I heavy chain together with IgM or platelet count
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DOI：
10.1016/j.bcmd.2008.09.003
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发表时间：
2009-01-01
影响因子：
2.3
通讯作者：
Dammacco, Franco
中科院分区：
文献类型：
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作者：
Perosa, Federico;Minoia, Carla;Dammacco, Franco
目的：在多发性骨髓瘤(MM)中，血清HLAI类分子的β2微球蛋白(β2M)-游离重链(FHC)被认为是反映疾病活动性的指标。我们调查了根据FHC和其他临床参数对活动期疾病患者进行分层的可能性。实验设计：我们研究了146例MM患者，其中100例在诊断时，31例在复发，15例治疗无效。采用单因素和多因素分析的方法，结合连续变量(年龄、白蛋白、肌酐、血红蛋白、血沉、β2M、钙、IgM、血小板计数)和分类变量(Durie-Salmon病分期、性别、骨病变负担、M组分重链和轻链亚型、临床状态)评估FHC的预后意义。结果：FHC、IgM、血小板计数、血红蛋白是影响MM患者预后的独立因素。这些变量的生存树分析定义了两个涉及FHC和IgM或血小板计数的三风险组分期系统。FHC/IgM期患者的中位生存期为41.5个月和27.8个月，而I期患者的中位生存期为41.5个月和27.8个月(P<0.05)。
Purpose: In multiple myeloma (MM), serum beta-2-microglobulin (beta 2m)-free heavy chains (FHC) of HLA class I has been shown to reflect disease activity. We investigated the possibility of stratifying patients with active disease according to FHC and other clinical parameters.Experimental design: We studied 146 patients with MM, including 100 at diagnosis, 31 in relapse and 15 unresponsive to therapy. Univariate and multivariate analyses were used to assess the prognostic significance of FHC together with continuous variables (age, albumin, creatinine, hemoglobin, erythrocyte sedimentation rate, beta 2m, calcium, IgM, platelet count) and categorical variables (Durie-Salmon disease stage, gender, bone lesion burden, heavy and light chain isotypes of M-component, clinical status). Survival tree analysis on significant variables was used to develop an MM staging system.Results: FHC, IgM, platelet count and hemoglobin were independent predictors of prognosis. Survival tree analysis of these variables defined 2 three-risk-group staging systems involving FHC and either IgM or platelet count. Median survival for FHC/IgM stages II and III was 41.5 and 27.8 months, whereas it was not reached for stage I patients (p