56例多发性骨髓瘤临床特点与细胞形态学分析

Analysis of Clinical Features and Cell Morphology in 56 Patients with Multiple Myeloma

目的探讨多发性骨髓瘤(MM)的主要临床特点、骨髓细胞形态学分型及其与MM预后关系。方法回顾性分析56例MM患者临床特征,观察骨髓瘤细胞的比例和形态特征,使用欧洲会议标准进行骨髓细胞形态学分型。结果 56例MM患者临床表现有骨痛35例(62.5%)、头晕或乏力15例(26.8%)、肾功能损害18例(32.1%)、出血或发热4例(7.1%)等,骨髓涂片中骨髓瘤细胞比例>10%的46例(82.1%),骨髓瘤细胞比例在6.0%～10.0%者2例(3.6%),骨髓瘤细胞比例≤5%者3例(5.4%),外周血涂片可见骨髓瘤细胞者10例(1%～10%);使用欧洲会议标准,成熟浆细胞型20例(37.5%),幼浆细胞型18例(32.1%)、原浆细胞型7例(12.5%)、网状细胞型6例(17.9%)。结论 MM的诊断中,骨髓细胞形态学具有特异诊断的意义,并对MM患者预后有一定指导意义。

Objective To investigate the clinical features in patients with multiple myeloma （MM） and the significance of bone marrow cell moiphology in MM diagnosis. Methods The clinical features of 56 patients with MM were retrospectively analyzed,investigate furtherly myeloma cell ratio and morphology type in bone marrow or peripheral blood smear slide by Europe conference standard of cell morpholgy. Results The clinical features in 56 patients with MM were osteodynia （35/56,62.5%） ,dizziness or fatigue （ 15/56,26. 8% ） ,renal functional abnormality（ 18/56,32. 1% ）, bleeding or fever（4/ 56,7. 1% ）. The patients with myeloma cell percentage 〉 10% in bone marrow slide were （46/56,82. 19% ）, patients with myeloma cell percentage between 6% - 10% were 2 （3.6%） ,The patients with myeloma cell in peripheral blood smear slide were 10 （the percentage of myeloma cell was between 1 % - 10% ）. According to the sixth europe hematology conference, The morphology type in bone marro include plasmablast, proplasmacyte, reticulocyte, mature plasme cell. In this study patients with plasmablast were 7 （ 12. 5 % ）, patients with proplasmacyte were 18 （32. 1% ）, patients with reticulocyte were 6 （ 17.9% ）, patients with mature plasme cell were 20 （37.5 % ）. Conclusion Morphology of bone marrow cell was an important and special method in MM diagnosis,and was very useful for progonosis of patients with MM.