红细胞分布宽度在老年非移植多发性骨髓瘤患者中的预后价值探讨

Prognostic Value of Red Blood Cell Distribution Width in Senile Potients with Non-trans planted Multiple Myeloma

目的:探讨红细胞分布宽度(RDW)在或不含硼替佐米的治疗方案治疗的老年非移植多发性骨髓瘤患者中的预后价值。方法:回顾性分析2007年1月1日至2015年12月31日99例初发的老年多发性骨髓瘤患者初诊时RDW和其他的临床参数(β-2微球蛋白,肌酐,乳酸脱氢酶);根据ROC曲线,将患者分为高、低RDW 2组,分析不同组别的生存预后。结果:高RDW组(≥17.95%)相对于低RDW组(<17.95%)血红蛋白及C反应蛋白较低,而瘤细胞比例较高。在不含硼替佐米方案治疗组中,单因素和多因素分析显示高RDW组的OS时间和PFS时间较短,而含硼替佐米方案治疗组中,高RDW组仅显示较短的PFS。结论:RDW作为一个简单易获取的实验室参数,在老年非移植的骨髓瘤病人中高RDW提示不良的预后,但是根据不同的治疗方案,预后呈现出一定的差异。

Objective: To investigate the prognostic value of red blood cell distribution width(RDW) in senile patients with non-transplanted multiple myeloma(MM). Methods: The RDW and clinical parameters such as β-2 microglobulin, creatiain, LDH and so on at diagnosis of 99 newly diagnosed senile MM patients were analysed retrospectively. The 99 patients were treated with chemotherapeutic regimens with or without bertezomib. The patients were divided into 2 groups: high( ≥17.95%) and low( <17.95%) RDW groups according to ROC curve, then the prognosis of patients was compared between high and low RDW groups. Results: The levels of hemoglobin and C-reactive protein in high RDW group were lower than those in low RDW group, while the ratio of myeloma cells in high RDW group was higher than that in low RDW group. The unvariate and multivariate analyses in patients trented with chemotherapeutic regimen without bertezomib showed that the overall survival(OS) and progress free survival(PFS) time were shorter, while the high RDW group demonstrated the showter PFS in patients treated with chemotherapeutic regimen including bortezomib. Conclusion: The RDW as a simple and easly available biomarker, suggests unfavorable prognosis for senile patients with non-transplanted MM;however the prognosis shows a certain difference on the basis of different chemotherapeutic regimens.