| 多发性骨髓瘤髓外病变的临床特征分析 |
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| 引用本文： | 陈婷,何国民,蔡亚云,徐娟,贲海祥,周丹丹,丁琳琳,宋清华. 多发性骨髓瘤髓外病变的临床特征分析[J]. 现代肿瘤医学, 2021, 0(14): 2510-2515. DOI: 10.3969/j.issn.1672-4992.2021.14.025 |
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| 作者姓名： | 陈婷 何国民 蔡亚云 徐娟 贲海祥 周丹丹 丁琳琳 宋清华 |
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| 作者单位： | 南通大学附属如皋人民医院血液科,江苏 南通 226500 |
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| 基金项目： | 江苏省南通市科技计划指导性项目计划(编号:MSZ19007);江苏省南通市卫生健康委员会科研立项课题（编号:QA2019047） |
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| 摘 要： | 目的:探讨多发性骨髓瘤髓外病变(extramedullary disease,EMD)的临床分子学特征及预后因素.方法:共纳入67例多发性骨髓瘤髓外病变患者和97例多发性骨髓瘤非髓外病变患者.EMD再分为两组:第一组是由溶骨性病变直接延伸的肿瘤(EM-B),而第二组则是骨髓瘤细胞浸润软组织(EM-S).两组间的计数资料...
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| 关 键 词： | 多发性骨髓瘤 髓外病变 异常循环浆细胞 临床结果 |
Analysis of clinical features of multiple myeloma with extramedullary disease |
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| CHEN Ting,HE Guomin,CAI Yayun,XU Juan,BEN Haixiang,ZHOU Dandan,DING Linlin,SONG Qinghua. Analysis of clinical features of multiple myeloma with extramedullary disease[J]. Journal of Modern Oncology, 2021, 0(14): 2510-2515. DOI: 10.3969/j.issn.1672-4992.2021.14.025 |
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| Authors: | CHEN Ting HE Guomin CAI Yayun XU Juan BEN Haixiang ZHOU Dandan DING Linlin SONG Qinghua |
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| Affiliation: | Hematology Department,the People's Hospital of Rugao Affiliated to Nantong University,Jiangsu Nantong 226500,China. |
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| Abstract: | Objective:To reveal the clinical molecular characteristics and prognostic factors of extramedullary disease (EMD).Methods:67 patients of multiple myeloma with EMD and 97 patients of multiple myeloma without EMD were included.EMD was divided into two groups.The first group comprised tumors that were extending directly from osteolytic bone lesions (EM-B).The second group comprised tumors that myeloma cells infiltrating soft tissue (EM-S).The prognostic factors were evaluated.Multivariate and univariate analyses were performed to identify risk factors associated with poorer overall survival (OS) of patients with EMD.Kaplan-Meier curves were generated to analyze the OS in the entire cohort.Results:Patients with EMD at initial presentation had unfavorable laboratory parameters of serum ferritin (SF)(P=0.035) and lactate dehydrogenase (LDH)(P=0.043) compared to those of patients without EMD.A greater proportion of patients in the EM-S group had t(4;14) at diagnosis compared to EM-B group (P=0.034).Compared with EM-B group,EM-S group had a higher incidence of multiple sites.The percent of abnormal circulating plasma cells (aCPCs) of EMD group was higher than no-EMD group (P=0.031).Ki-67 proliferation index of EMD tissue was significantly higher than bone marrow (P=0.019).Kaplan-Meier curve showed the OS in no-EMD group was significantly higher than EMD group (P=0.012).EM-S group indicated lower OS.Conclusion:SF,LDH and aCPCs may be the possible early warning factors for the occurrence of EMD.t(4;14) and high SF level can be used as predictors of EM-S.In the OS analysis,EMD and EM-S group were associated with worse outcome.Conventional chemotherapy can not improve the prognosis of EMD patients,and new clinical trials must be actively conducted. |
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| Keywords: | multiple myeloma extramedullary disease abnormal circulating plasma cells clinical outcomes |
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