Review of 1027 patients with newly diagnosed multiple myeloma
Review of 1027 patients with newly diagnosed multiple myeloma
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DOI：
10.4065/78.1.21
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发表时间：
2003-01-01
影响因子：
8.9
通讯作者：
Greipp, PR
中科院分区：
文献类型：
--
作者：
Kyle, RA;Gertz, MA;Greipp, PR
为了确定新诊断的多发性骨髓瘤的临床和实验室特征。患者和方法：最初从1985年1月1日至1998年12月31日在明尼苏达州罗切斯特市的梅奥诊所诊断出多发性骨髓瘤的所有记录。审查。分析：在1027名研究患者中，有2％的年龄小于40岁，而38％的患者年龄在70岁或以上。中位年龄为66岁。贫血最初存在于73％的患者中，13％的高钙血症（钙水平为41 mg/dL），而血清肌酐水平为2 mg/dl或以上为19％。 β（2） - 微球蛋白水平升高为75％。血清蛋白电泳显示82％的患者中有局部带，免疫亲子或免疫固定显示出93％的单克隆蛋白。在78％的尿液中发现了一个单克隆轻链。非分泌性骨髓瘤-WA在3％的患者中识别出，而轻链骨髓瘤则为20％。常规X光片显示出79％的异常。在34％的患者中，血浆细胞标记指数为1％或更多。多变量分析表明，年龄，浆细胞标记指数，低血小板计数，血清白蛋白值以及肌酐值的日志是最重要的预后因素。结论：生存期间的中位数为33个月，从1985年开始没有改善到1998年。
To determine the clinical and laboratory features of newly diagnosed multiple myeloma.Patients and Methods: Records of all patients in whom multiple myeloma was initially diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1985, to December 31, 1998, were reviewed.Results: Of the 1027 study patients, 2% were younger than 40 years, and 38% were 70 years or older. The median age was 66 years. Anemia was present initially in 73% of patients, hypercalcemia (calcium level 41 mg/dL) in 13%, and a serum creatinine level of 2 mg/dL or more in 19%. The beta(2)-microglobulin level was increased in 75%. Serum protein electrophoresis revealed a localized band in 82% of patients, and immunoelectrophoresis or immunofixation showed a monoclonal protein in 93%. A monoclonal light chain was found in the urine in 78%. Non- secretory myeloma-was recognized in 3% of patients, whereas light-chain myeloma was present in 20%. Conventional radiographs showed an abnormality in 79%. The plasma cell labeling index was 1% or more in 34% of patients. Multivariate analysis revealed that age, plasma cell labeling index, low platelet count, serum albumin value, and,the log of the creatinine value were the most important prognostic factors.Conclusion: The median duration of survival was 33 months and did not improve from 1985 through 1998.