Ting Chen, Jia-Mei Ji, Ya-Ting Li, Lei Fan, Li-Juan Chen, Jian-Yong Li, Xiao-Yan Qu
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引用次数: 1
Abstract
Objective: To analyze the clinical characteristics of multiple myeloma(MM) patients with early relapse.
Methods: A total of 50 MM patients with early relapse (≤12 months) and 50 matched controls with late relapse (>12 months) were selected. The time from diagnosis to relapse and related clinical data of the 100 patients were retrospectively analyzed, and the factors associated with early relapse were identified. Kaplan-Meier curve was used to analyze the overall survival (OS) time of the whole cohort. Area under the curve (AUC) was used to evaluate the effect of circulating plasma cells on early recurrence of the patients.
Results: The results showed that high-risk cytogenetics (FISH) (P=0.005), and ISS stage III (P=0.008) were associated with early recurrence of the patients. For patients with early relapse, high-risk FISH showed poor survival. Compared with the patients with late relapse, most of the chromosome karyotype of patients with early relapse showed quantitative and structural abnormalities. The expression of circulating plasma cells was significantly increased in patients with early recurrence group (P=0.0318). The response to initial treatment was poor in the early recurrence group (P=0.001), and the prognosis was significantly worse than those in the late recurrence group (median OS: 38 vs 81 months, P=0.002).
Conclusion: Early relapse is a marker poor prognostic in MM patients, and such patients should be focused on the improving their prognosis.
目的:分析多发性骨髓瘤(MM)早期复发患者的临床特点。方法:选择早期复发(≤12个月)的MM患者50例和晚期复发(>12个月)的匹配对照50例。回顾性分析100例患者从诊断到复发的时间及相关临床资料,明确早期复发的相关因素。采用Kaplan-Meier曲线分析整个队列的总生存时间(OS)。采用曲线下面积(Area under the curve, AUC)评价循环浆细胞对患者早期复发的影响。结果:高危细胞遗传学(FISH) (P=0.005)和ISS III期(P=0.008)与患者早期复发相关。对于早期复发的患者,高危FISH生存率较差。与晚期复发患者相比,早期复发患者的染色体核型多数表现为数量和结构异常。早期复发组循环浆细胞表达明显升高(P=0.0318)。早期复发组对初始治疗的反应较差(P=0.001),预后明显差于晚期复发组(中位OS: 38 vs 81个月,P=0.002)。结论:早期复发是MM患者预后不良的标志,应重视改善预后。