初治多发性骨髓瘤患者血清IL-6的预后价值分析

本研究旨在探讨初治多发性骨髓瘤（MM）患者血清IL-6的预后价值。回顾性分析238例MM患者初诊时血清IL-6水平，比较不同IL-6水平患者的临床特点以及与疾病预后的关系。结果表明，血清IL-6水平大于100pg／ml的MM患者，其ECOG评分大于3患者比例、MBD2-4级患者比例、血肌酐水平明显高于IL-6水平小于100pg／m1的MM患者。两组在年龄、核型异常比例、FISH检测13号染色体缺失者比例、血磷水平、低血钙患者比例、血清β2-MG水平、CD138＋／CD38＋细胞比例以及血清Hb、cRP、Alb、LDH水平、治疗反应等均无明显差异。血清IL-6水平小于100pg／ml组以及大于100pg／ml组的疾病进展时间（TTP）分别为：23个月、14个月（P=1．93）；两组的总体生存时间（OS）分别为：35个月、29个月（P=0．04）。结论：不同IL-5水平患者的临床特点及疾病预后具有明显差异。在临床实践中，应用放射性免疫的方法检测初诊患者血清IL-6水平可作为MM患者的常规检查，可有效地提示患者的病情及预后。

Prognostic Value of Serum IL-6 in Patients with Multiple Myeloma

This study was aimed to evaluate the prognostic value of serum IL-6 （sIL-6） in patients with multiple my- eloma（MM）. The sIL-6 level in 288 patients with MM was retrospectively analyzed, and the clinical characteristics and prognosis in patients with different IL-6 level were compared. The newly diagnosed patients with MM were divided into two groups： the low sIL-6 group （ sIL-6 〈 100 pg/ml ） and the high sIL-6 group （ slL-6 〉t 100 pg/ml ）. The results showed that high slL-6 level was more common in patients with ECOG score 〉 3, myeloma bone disease （MBD） be- tween grade 2 to 4, and high creatinine level. There was no significant differences in age, abnormal karyotype percent- age, chromosome 13q14 abnormality percentage, CD138 ＋/CD38 ＋ cells percentage and the level of calcium, phosphor- us, albumin, C-reactive protein, 132-MG, lactate dehydrogenase, hemoglobin, platelet between the two groups at diag- nosis, and also no significant difference in response to initial induction chemotherapy among the two groups. The overall survival was significantly different between the low and high IL-6 groups （ P =0.04, 35 m vs 29 m）, but no difference in time to progress between the two groups（ P = 1.93, 23 m vs 14 m）. It is concluded that the sIL-6 level correlates with the clinical characteristics and prognosis. Radioimmunoassay is an appropriate measurement for human IL-6 in serum, and suitable for clinical application.