CD20^+多发性骨髓瘤的临床特点和治疗研究

Clinical Characteristics and Treatment of Multiple Myeloma with Positive Expression of CD20

目的探讨CD20^+多发性骨髓瘤的发病情况、临床特点及治疗选择。方法回顾性分析2012年1月至2014年12月在北京大学第三医院确诊的CD20^+多发性骨髓瘤患者资料。结果共确诊143例多发性骨髓瘤患者,其中CD20阳性者12例,占同期骨髓瘤患者的8.4%;12例CD20阳性患者的中位发病年龄为55.5(40~81)岁,骨髓瘤细胞表面均表达CD20,但CD20的表达强度不同,仅有CD20^(dim)表达4例,CD20^(bright)表达2例;6例同时存在CD20^(bright)和CD20^(dim)的表达,其中4例CD20^(dim)的比例高,2例CD20^(bright)的比例高。12例患者中位生存时间22(1~40)月,其中3例获得CR,4例进展较快,在14月内死亡,1年总体生存率为83.3%。结论 CD20^+骨髓瘤患者的疾病过程具有多发性骨髓瘤的特点,部分患者经过治疗可以获得缓解;也有部分患者进展较快,而CD20的表达提供了一种可能的治疗选择。

Objective To analyze the clinical manifestations, diagnosis, therapy and prognosis of CD20＋ multiple myeloma. Methods From Jan 1, 2012 to Dec 31, 2014, there were 143 patients were diagnosed with multiple myeloma altogether, among them 8.4%（12/143） patients with CD20 positive expression. Results The median age is 55.5（40-81） years old. Among the 12 patients with CD20 positive expression, 33.3%（4/12） cases were CD20^（dim） only whereas 16.7%（2/12） were CD20^（bright） only. The other 6 cases were positive with both CD20^（bright） and CD20^（dim）, 4 cases had more percentage of CD20^（dim） and 2 cases had more percentage of CD20^（bright）. Among 12 cases, median survival time was 22（1-40） months, 3 patients achieved CR and 4 patients were dead, 1-year overall survival was 83.3%. Conclusion The clinical course of CD20~＋multiple myeloma was typically similar with multiple myeloma, after treatment some can acquire complete remission, but some patients got rapid progress of the disease.