老年多发性骨髓瘤初治患者放弃化疗状况及相关因素分析

Analysis of influencing factors for giving up chemotherapy during initial treatment in elderly multiple myeloma

目的 分析老年多发性骨髓瘤初治患者放弃化疗状况及其相关因素,为临床提高患者的化疗依从性提供依据.方法 回顾性分析2000-2010年在我院血液科住院、符合临床诊断标准的老年初治多发性骨髓瘤患者156例,随机抽取同期住院的中青年多发性骨髓瘤患者123例作为对照组,统计放弃化疔原因,并进行相关因素分析.结果 老年组初治患者放弃化疗率为58.3％（91/156）,对照组为35.0％（43/123）,两组比较差异有统计学意义（P＜0.05）.放弃治疗的91例老年患者中,51.7％确诊后未接受化疗.老年患者放弃化疗的主要原因依次为病情危重、经济困难和耐受性差;而对照组主要原因为经济困难.结论 老年多发性骨髓瘤初治患者放弃化疗的比率较高,高龄、病情危重、经济困难、耐受力差是放弃化疗的独立危险因素.

Objective To study influencing factors for giving up chemotherapy during initial treatment in elderly patients with multiple myeloma.Methods A total of 156 elderly patients diagnosed as multiple myeloma from 2000-2010 were retrospectively analyzed.And 123 young patients with multiple myeloma were selected as control group.The causes for giving up the chemotherapy and its related factors were recorded and analyzed.Results The rate of giving up the initial chemotherapy was higher in the elderly than in young patients [58.3% （91/156） vs.35.0% （43/123）,P〈0.05].51.7% of the elderly patients did not accept chemotherapy after diagnosis.The main factors for giving up the initial chemotherapy in elderly patients were critically ill,economic difficult and the low tolerance.However,the economic difficulty was the first cause in the young group.Conclusions The rate of giving up the chemotherapy in the elderly patients is high.Old age,severe conditions,economic difficulty,and low tolerance are the independent factors.