多发性骨髓瘤治疗后血清游离轻链比值正常化对预后的影响

本研究旨在探讨多发性骨髓瘤治疗后血清游离轻链比值（sFLCR）正常化及其对预后的影响。回顾性分析2009年1月至2013年12月我院42例多发性骨髓瘤患者的临床资料,将多发性骨髓瘤患者治疗后获得最好疗效时sFLCR持续正常超过4周的患者归为正常化轻链比患者,反之为异常轻链比患者;分析其传统预后因素对sFLCR的影响及sFLCR对患者总生存期（OS）的意义。结果表明,多发性骨髓瘤患者的年龄、ISS分期在正常化sFLCR组及异常sFLCR组之间存在统计学差异,上述两种指标对治疗后骨髓瘤sFLCR均有负性影响（P〈0.05）;sFLCR达到正常化血轻链比值患者具有相对较好的总生存期（P〈0.01）。结论：治疗后sFLCR正常化能够初步提示多发性骨髓瘤的预后较好。

Effect of Free Light Chain Ratio Normalization after Treatment on Prognosis of Patients with Multiple Myeloma

This study was aimed to investigate the normalization of serum free light chain ratio（ sPLCR）after treatment of multiple myeloma（ MM）and its influence on the prognosis of MM patients.The clinical data of 42 patients with MM were analyzed retrospectively from January 2009 to November 2013 in out department.According to sPLCR consecutive normalization for more 4 weeks or not after treatmentthe patients were classified in patients with mormalized sPLCR and patients with abnormalized sPLCRthen the influence of traditional prognostic factors of MM on sPLCR and effect of sPLCR on overall survival（ OS）time of MM patients were analyzed.The results showed that the influence of ageISS stage displayed statistical difference between sFLCR normalization group and abnormalization groupthe age65 years and ISS stage Ⅲ negatively impacted on sFLCR normalization（ P〈0.05）.The response rates of patients with normalized sFLCR were as followsCR — 60%VGPR — 38.89%PR — 28.57%17 patients（ 40.48%）with sFLCR normalization showed superior OSas compared with patients with sPLCR abnormalization（ P 〈0.01）.It is concluded that the sFLCR normalization is the independent prognostic factor for MMsuggesting that the MM patients with sPLCR normalization after treatment have superior prognosis.