Objective: To investigate the influence of renal function on the level of β₂-microglobulin (β₂-MG) as prognostic factor in newly diagnosed multiple myeloma (MM) patients, and to analyze the overall survival (OS) in different level of β₂-MG with relatively normal or abnormal renal function in MM patients.
Methods: According to the level of β₂-MG, 666 newly diagnosed MM patients were divided into three groups as β₂-MG<3.5, 3.5-<5.5, ≥5.5 mg/L. According to the level of serum creatinine, these patients were divided into two groups:serum creatinine <177 μmol/L as relatively normal group, serum creatinine ≥177 μmol/L as abnormal group.
Results: Among 666 patients, there were 416 male and 250 female, the median age was 58 (25-86) years old. Comparison of OS among β₂-MG<3.5, 3.5-<5.5, ≥5.5 mg/L groups indicated that the median OS of the three groups were 85.75 (95% CI 70.99-100.50), 47.25 (95% CI 40.98-53.53) and 35.05 (95% CI 30.75-39.35) months, respectively (P<0.01). Comparison of OS between serum creatinine <177 and ≥177 mmol/L groups, the median OS of the two groups were 64.67 (95% CI 56.57-72.77) and 32.74 (95% CI 27.74-37.73) months, respectively (P<0.01). In β₂-MG≥5.5 mg/L, the median OS of relatively normal and abnormal groups were 37.25 (95% CI 31.45-43.06) and 32.55 (95% CI 26.26-38.83) months, respectively (P=0.142).
Conclusion: High level of β₂-MG and renal function correlated with shorter survival of MM patients. Higher level of β₂-MG with abnormal renal function can't change the prognostic value of β₂-microglobulin on MM.
目的: 分析不同β2微球蛋白(β2-MG)水平合并或不合并肾功能异常的初诊多发性骨髓瘤(MM)患者的生存情况,探讨肾功能对β2微球蛋白作为MM预后因素的影响。
方法: 对1999年2月至2013年10月666例初诊MM患者临床资料进行回顾性分析,以血肌酐<177 µmol/L为肾功能相对正常组,血肌酐≥177 µmol/L为肾功能异常组,分析不同β2-MG水平及肾功能状态患者总生存(OS)情况。
结果: 666例患者中男416例,女250例,中位年龄58(25~86)岁。β2-MG<3.5、3.5~<5.5及≥5.5 mg/L患者分别为208、173及285例,其OS时间分别为85.75(95%CI 70.99~100.50)、47.25(95%CI 40.98~53.53)及35.05(95%CI 30.75~39.35)个月,差异有统计学意义(P<0.01)。肾功能相对正常与肾功能异常患者OS时间分别为64.67(95%CI 56.57~72.77)及32.74(95%CI 27.74~37.73)个月,差异有统计学意义(P<0.01)。在β2-MG≥5.5 mg/L的患者中,肾功能相对正常与肾功能异常患者OS时间分别为37.25 (95%CI 31.45~43.06)、32.55(95%CI 26.26~38.83)个月,差异无统计学意义(P=0.142)。
结论: 高水平β2-MG、肾功能异常MM患者生存时间较短,是否合并肾功能异常并未改变β2-MG作为MM国际分期系统预后因素的影响。