硼替佐米对CD56阴性的多发性骨髓瘤患者的疗效研究

Study on the efficacy of bortezomib on CD56 negative multiple myeloma patients

目的·研究硼替佐米对CD56阴性的多发性骨髓瘤(MM)患者的疗效及预后的影响。方法·研究对象为160例初治MM患者,采用流式细胞术检测治疗前骨髓细胞的免疫表型;按治疗方案的不同,将所有病例分为硼替佐米为基础的治疗方案组(硼替佐米组)110例和非硼替佐米为基础的治疗方案组(非硼替佐米组)50例,观察2组疗效。采用Kaplan-Meier生存曲线评估患者的无病生存期(PFS)及总生存期(OS),确定相关因素与预后的关系。结果·免疫表型CD56阴性和阳性患者的PFS间差异无统计学意义(P=0.159),OS间差异有统计学意义(P=0.013),CD56阴性患者的预后较差。硼替佐米组和非硼替佐米组患者的PFS间差异无统计学意义(P=0.26),但硼替佐米组患者的OS显著高于非硼替佐米组(P=0.02)。在非硼替佐米组中,CD56阴性和阳性患者的PFS间差异无统计学意义(P=0.16),OS间差异有统计学意义(P=0.04);在硼替佐米组中,CD56阴性和阳性患者的PFS和OS间差异均无统计学意义(PFS:P=0.50。OS:P=0.15)。结论·CD56是MM的预后标志物之一,CD56阴性的MM患者可能预后不佳,而硼替佐米对CD56阴性的MM患者的预后有一定改善作用。

Objective·To investigate the effects of bortezomib on efficacy and prognosis in CD56 negative multiple myeloma （MM） patients. Methods·One hundred and sixty newly diagnosed MM patients were enrolled in this study. The immunophenotypes of myeloid cells were examined by flow cytometry before treatment. The patients were assigned to two groups based on treatment regimen. One hundred and ten cases received bortezomib based treatment （bortezomib group） and 50 cases received non-bortezomib regimens （non-bortezomib group）. The efficacy in the two groups was observed. Kaplan-Meier method was used to evaluate the progression-free survival （PFS） and overall survival （OS） and determine the association between relevant factors and the prognosis. Results·There was no statistical difference between CD56 positive and negative patients in terms of PFS （P=0.159）, but the difference in OS was statistically significant （P=0.013）. CD56 negative patients had poor prognosis. No difference was observed in PFS between bortezomib and non-bortezomib groups （P=0.26）, but bortezomib group had significantly higher OS than non-bortezomib group （P=0.02）. No statistical difference was found in PFS between CD56 positive and negative patients in non-bortezomib group （P=0.16）, while the difference in OS was statistically significant （P=0.04）. The differences in PFS and OS between CD56 positive and negative patients in bortezomib group were not statistically significant （P=0.50 for PFS; P=0.15 for OS）. Conclusion·CD56 can be a prognosis factor for MM. CD56 negative MM patients may have poor prognosis. Bortezomib may improve the prognosis of CD56 negative MM patients.