14例髓外浆细胞瘤患者的临床特征分析及治疗

Clinical analysis and treatment of 14 multiple myeloma patients with extramedullary plasmacytoma

目的:探讨伴髓外浆细胞瘤(extramedullary plasmacytoma,EMP)的多发性骨髓瘤(multiple myeloma,MM)患者的临床特点,治疗选择及预后。方法:对14例确诊的伴髓外浆细胞瘤的多发性骨髓瘤进行回顾性分析。结果:14例患者男女比为1:l,中位年龄56.9岁。9例患者初诊时即出现EMP,5例在治疗过程中发生。治疗选择包括化疗,手术,放疗或自体移植。6例患者单发EMP,8例多发EMP(multiextramedullary plasmacytomas,MEP);单发患者中5例部分或接近完全缓解,1例病情进展;多发患者中5例死亡,1例病情进展,2例部分缓解。结论:MM伴有MEP者对常规化疗反应差,预后不良,需要探讨新的治疗策略。

Objective： This study aimed to investigate the clinical characteristics, treatment options, and prognosis of multiple myeloma （MM） patients complicated with extramedullary plasmacytoma （EMP）. Methods：The case of MM concurrent with EMP are rare. During the period between June 2005 and June 2013, clinical experience, diagnosis, and treatment of MM with EMP cases were retrospectively analyzed. Results：Fourteen cases were diagnosed with MM complicated with EMP in the Third Hospital of Peking Uni-versity, Beijing, China. Among these 14 cases, seven were males and seven were females. The mean age of patients was 56.9 years （ranging from 40 to 80 years old）. Nine of the cases were diagnosed with EMP during the preliminary diagnosis, and the remaining five cases developed EMP during the course of treatment. Among the 14 cases, six were solitary EMPs and eight were multiple EMPs. Among the multiple EMP cases, five died, one showed disease progression, and two demonstrated partial regression. Conclusion：The prognosis of MM complicated with EMP is poor. Thus, new treatment strategies should be further explored.