Immunoglobulin free light chains and solitary plasmacytoma of bone
Immunoglobulin free light chains and solitary plasmacytoma of bone
复制标题
DOI：
10.1182/blood-2006-04-015784
复制
发表时间：
2006-09-15
期刊：
影响因子：
20.3
通讯作者：
Katzmann, Jerry A.
中科院分区：
文献类型：
--
作者：
Dingli, David;Kyle, Robert A.;Katzmann, Jerry A.
诊断时异常的血清免疫球蛋白游离轻链（FLC）比率可以识别孤立性骨浆细胞瘤（SBP）患者进展为骨髓瘤的风险。在116例患者中，43例进展为骨髓瘤，中位进展时间为1.8年。116例患者均在诊断时采集血清检测FLC，其中54例（47%）异常。异常FLC比率与骨髓瘤进展的高风险相关（P = 0.039）。诊断时血清FLC比率异常的患者5年进展风险为44%，而FLC比率正常的患者为26%。诊断后1至2年，血清M蛋白水平持续为5 g/L （0.5 g/dL）或更高是病情进展的另一个危险因素。采用FLC比率和M蛋白水平2个变量构建风险分层模型：诊断后1 ~ 2年，基线FLC比率正常，M蛋白水平低于5 g/L （0.5 g/dL）的患者（低危，n = 31）；任一危险因素异常（中等危险，n = 26）；FLC比值异常和M蛋白水平≥5 g/L (0.5 g/dL)（高危人群，n = 18）。5年相应的进展率在低、中、高组中有显著差异：分别为13%、26%和62% （P < 0.001）。
An abnormal serum immunoglobulin free light chain (FLC) ratio at diagnosis may identify risk of progression to myeloma in patients with solitary bone plasmacytoma (SBP). In the cohort of 116 patients, 43 have progressed to myeloma, with a median time to progression of 1.8 years. The FLC ratio was determined in all 116 patients on serum collected at time of diagnosis and was abnormal in 54 patients (47%). An abnormal FLC ratio was associated with a higher risk of progression to myeloma (P = .039). The risk of progression at 5 years was 44% in patients with an abnormal serum FLC ratio at diagnosis compared with 26% in those with a normal FLC ratio. One to 2 years following diagnosis, a persistent serum M protein level of 5 g/L (0.5 g/dL) or higher was an additional risk factor for progression. A risk stratification model was constructed using the 2 variables of FLC ratio and M protein level: patients with a normal FLC ratio at baseline and M protein level less than 5 g/L (0.5 g/dL) at 1 to 2 years following diagnosis (low risk, n = 31); with either risk factor abnormal (intermediate risk, n = 26); and with both an abnormal FLC ratio and M protein level of 5 g/L (0.5 g/dL) or higher (high risk, n = 18). The corresponding progression rates at 5 years were significantly different in the low, intermediate, and high groups: 13%, 26%, and 62%, respectively (P < .001).