三级医疗机构多发性骨髓瘤国际分期体系现状及复发趋势。

Mymensingh medical journal : MMJ Pub Date : 2025-01-01
M M Alam, M A Khan, M Akter, M Wasim, M N Alam, R Nahar, T Islam, M S Basher, M N Islam, M N Karim
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引用次数: 0

摘要

多发性骨髓瘤(MM)是一种起源于成熟b细胞谱系的血液肿瘤。其特征是浆细胞的异常克隆增殖和血清和/或尿液中存在单克隆蛋白。本研究旨在观察国际分期系统(ISS)的现状及复发趋势。这项描述性横断面研究于2019年1月至2020年7月在孟加拉国达卡达卡医学院医院血液科进行,共有81名多发性骨髓瘤患者。首席研究员在获得知情同意后使用病例记录表(CRF)收集数据。考虑到相关的道德问题和数据质量保证。数据采用SPSS 25.0版统计软件包进行分析。采用卡方检验、Fisher精确检验和Yate校正卡方检验,在5%显著性水平下评估统计相关性。多发性骨髓瘤患者的平均年龄为58.9±12.0岁。男女比例接近2:1。ISS III期占59.4%,溶解性病变占75.0%,平均骨髓浆细胞(BMPC)百分比为62.1±24.9%。免疫固定电泳(IFE)显示IgG Kappa(47.3%)、IgG Lambda(25.5%)、IgA Lambda(10.9%)、IgA Kappa(7.2%)和游离轻链(9.1%)。Kappa λ比为60.7:39.3。游离轻链(FLC)比值≥100者占29.0%。五分之四(80.2%)为新发病例,近五分之一(19.8%)为复发病例。平均复发或难治性持续时间为37.6±19.4个月。在晚期ISS分期与难治性或复发之间观察到显著的相关性。1小时红细胞沉降率(ESR)、FLC比值、FISH细胞遗传学、免疫固定电泳(IFE)和治疗方案与复发或难治性无统计学相关性(p < 0.05)。相当多的病例是从头开始的;而近五分之一的人是旧病复发。平均持续时间为37.6±19.4个月。患者接受既定的化疗方案治疗。随着时间的推移,约五分之一的患者出现难治性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
International Staging System Status and Trend of Relapse in Multiple Myeloma Cases in a Tertiary Level Health Care.

Multiple myeloma (MM) is a haematological neoplasm of mature B-cell lineage origin. It is characterized by abnormal clonal proliferation of plasma cells and presence of monoclonal protein in serum and / or urine. This study was conducted to observe the International Staging System (ISS) status and trends of relapse. This descriptive cross-sectional study was performed in the department of Haematology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2019 to July 2020 among 81 purposively selected Multiple myeloma patients. Principal investigator collected data using Case Record Form (CRF) after obtaining informed consent. Relevant ethical issues and data quality assurance were taken into consideration. Data were analyzed with Statistical Package for Social Sciences (SPSS), Version 25.0. Chi square test, Fisher's exact test and Chi square test with Yate's correction were carried out as appropriate with five percent level of significance for assessing statistical association. Mean age of patients with Multiple myeloma was 58.9±12.0 years. Male female ratio was nearly 2:1. ISS stage III was in 59.4 percent cases, lytic lesions were present in 75.0% and mean Bone Marrow Plasma Cell (BMPC) percentage was 62.1±24.9 percent. Immuno-Fixation Electrophoresis (IFE) revealed IgG Kappa (47.3%), IgG Lambda (25.5%) IgA Lambda (10.9%), IgA Kappa (7.2%) and Free Light Chain (9.1%). Kappa lambda ratio was 60.7:39.3. Free Light Chain (FLC) ratio ≥100 was in 29.0 percent cases. Four-fifths 65(80.2%) cases were de novo, while nearly one-fifth 16(19.8%) were the relapsed cases. Mean duration to become relapsed or refractory was 37.6±19.4 months. Significant association was observed among advanced ISS staging with refractory or relapse. Erythrocyte sedimentation rate in 1st hour (ESR), FLC ratio, FISH cytogenetics, Immunofixation electrophoresis (IFE) and treatment protocol was not found to have statistical association with relapse or refractoriness (p>0.05). A significant number of cases are de novo; while nearly one in five are relapsed one. Mean duration for refractoriness is 37.6±19.4 months. Patients are treated with established chemotherapeutic protocols. About one-fifth of patients developed refractoriness with progression of time.

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