[Clinical analysis of multiple myeloma-associated amyloidosis]

Zhonghua Yi Xue Za Zhi. 2018 Jan 30;98(5):365-369. doi: 10.3760/cma.j.issn.0376-2491.2018.05.010.
[Article in Chinese]

Abstract

Objective: To investigate the clinical features and survival of multiple myeloma-associated amyloidosis patients. Methods: Twenty three multiple myeloma-associated amyloidosis patients were retrospectively analyzed from January 2009 to December 2016. Results: The overall response rate(ORR)was 65.2% and the remission rate (sCR+ CR) was 21.7%. The median progression-free survival(PFS) was fourteen months(1-63), and the median overall survival(OS)was fifteen months(3-63). The early death rate (death rate within one year)was 33.3%. The median OS of patients(n=9)with the performance status(PS) score >2 was seven months(1-15), and the median OS of patients(n=14)with the PS score ≤2 was thirty months(10-63). There was a statistically significant difference in OS(P<0.05); the median PFS and OS of the patients (n=15) who responded to inductive treatment were seventeen months(2-63) and twenty four months (4-63)respectively, and the median PFS and OS of the patients (n=8)who did not respond to inductive treatment were three months(1-8) and eleven months (3-15) respectively. There was a statistically significant difference in PFS and OS(P<0.05). There was a statistically significant difference in PFS and OS between patients treated with remission (n=5)and those who did not(n=18) (P<0.05). Conclusions: The multiple myeloma-associated amyloidosis patients had a high early death rate and short survival time. Early identification and effective treatment are the preconditions for improving the poor prognosis.

目的: 探讨多发性骨髓瘤伴发淀粉样变性患者的临床特点以及生存情况。 方法: 回顾性分析2009年1月—2016年12月北京朝阳医院京西院区血液科收治的23例多发性骨髓瘤伴发淀粉样变性患者的临床资料。 结果: 治疗总有效率(ORR)为65.2%,缓解[严格完全缓解(sCR)+完全缓解(CR)]率为21.7%;中位无进展生存(PFS)期为14(1~63)个月,中位总生存(OS)期为15(3~63)个月,早期死亡率(1年内死亡率)33.3%;体能状态(PS)评分>2分的患者(n=9)中位OS为7(1~15)个月,PS评分≤2分的患者(n=14)中位OS期30(10~63)个月,两组的总生存期比较,差异有统计学意义(P<0.05)。诱导治疗有效的患者(n=15)与无效的患者(n=8),中位PFS期分别为17(2~63)个月和3(1~8)个月,中位OS分别为24(4~63)个月和11(3~15)个月,分别比较PFS期和OS期,差异均有统计学意义(均P<0.05)。诱导治疗缓解的患者(n=5)与未缓解的患者(n=18),PFS期和OS期差异均有统计学意义(均P<0.05)。 结论: 多发性骨髓瘤伴发淀粉样变性的患者早期死亡率高,生存期短;早期识别和有效治疗是改善其不良预后的前提。.

Keywords: Amyloidosis; Multiple myeloma; Prognosis.

MeSH terms

  • Amyloidosis
  • Antineoplastic Combined Chemotherapy Protocols
  • Disease-Free Survival
  • Humans
  • Multiple Myeloma*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome