EARLY RESPONDER MYELOMA - KINETIC-STUDIES IDENTIFY A PATIENT SUBGROUP CHARACTERIZED BY VERY POOR PROGNOSIS
EARLY RESPONDER MYELOMA - KINETIC-STUDIES IDENTIFY A PATIENT SUBGROUP CHARACTERIZED BY VERY POOR PROGNOSIS
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DOI：
10.1200/jco.1989.7.1.119
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发表时间：
1989-01-01
影响因子：
45.3
通讯作者：
PILERI, A
中科院分区：
文献类型：
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作者：
BOCCADORO, M;MARMONT, F;PILERI, A
为评价多发性骨髓瘤(MM)患者肿瘤质量快速减少对预后的预测价值，对100例MM患者进行了分析，并在诊断时评估了骨髓浆细胞动力学特征。42名患者接受了肿瘤减量治疗。50%的患者在3个月内接受3个周期的化疗(早期有效的骨髓瘤[ERM])，23%的患者在>；3个月内接受化疗(慢反应的骨髓瘤[SRM])。两组存活率差异无统计学意义(P=0.07)。ERM患者的骨髓浆细胞标记指数(LI)显著高于SRM患者(1.8.+-.2.0对0.8。+-。0.7，P=0.006)。LI被用来将ERM患者分为两个明确的亚组。伴有LI的ERM患者。2%的患者中位生存期为16.4个月，而2%的ERM患者的中位生存期为46.9个月(P<；.0044)。缓解时间也有显著差异：高LI亚组为12.2个月，低LI亚组为26.3个月(P<；0.0025)。早期反应本身并不对应于较短的缓解时间和较短的生存期，但如果与浆细胞的高增殖活性有关，则是一个较差的预后因素。
In order to assess the prognostic value of rapid tumor mass reduction in responding multiple myeloma (MM) patients, 100 consecutive patients were analyzed, and bone marrow plasma cell kinetic characteristics were evaluated at diagnosis. Forty-two patients obtained a tumor mass reductin .gtoreq. 50% with three cycles of chemotherapy and within 3 months (early responder myeloma [ERM]), and 23 in > 3 months (slow responder myeloma [SRM]). Survival rates in these two groups were not statistically different (P = .07). The labeling index (LI) of bone marrow plasma cells was significantly higher in ERM patients than in SRM patients (1.8 .+-. 2.0 v 0.8 .+-. 0.7, P = .006). The LI was used to separate the ERM patients into two well-defined subgroups. ERM patients with a LI .gtoreq. 2% showed a median survival of 16.4 months, whereas ERM patients with a LI < 2% did not reach the median survival at 46.9 months (P < .0044). Remission duration was also significantly different: 12.2 months in the high LI subgroup and 26.3 months in the low LI subgroup (P < .0025). Early response itself does not correspond to shorter remission duration and shorter survival, but it is a poor prognostic factor if associated with a high plasma cell proliferative activity.