初诊多发性骨髓瘤患者外周血ALC与临床特征及预后的关系

Association of peripheral ALC with clinical features and prognosis in newly diagnosed multiple myeloma patients

目的探讨多发性骨髓瘤(multiple myeloma,MM)患者初诊外周血淋巴细胞绝对数(absolute lymphocyte count,ALC)与临床特征及预后的关系。方法回顾性分析初诊MM患者50例。根据中位ALC水平(1.46×109/L),将其分为ALC低水平组(ALC<1.46×109/L)和ALC高水平组(ALC≥1.46×109/L)各25例。根据临床资料及实验室检查结果分析ALC与初诊MM患者的临床特征和预后的关系。结果 ALC低水平组外周血白细胞(white blood cell,WBC)计数、血红蛋白(hemoglobin,Hb)和血小板(platelet,Plt)计数指标均低于ALC高水平组(均P<0.05)。ALC低水平组血清乳酸脱氢酶(lactate dehydrogenase,LDH)值和β2-微球蛋白(β2-microglobulin,β2-MG)指标均高于ALC高水平组(均P<0.05)。ALC低水平组和ALC高水平组治疗后缓解例数分别为13例(52.0%)和18例(72.0%),两组比较差异无统计学意义(P=0.075)。ALC低水平组患者生存率低于ALC高水平组(56.0%vs 80.0%,P<0.05)。结论初诊ALC水平低的患者生存率较低。ALC水平与MM的多个预后因素密切相关,可考虑作为MM判断预后的辅助指标。

Objective To investigate the association of peripheral blood lymphocyte count（ ALC） with clinical features and prognosis in newly diagnosed multiple myeloma（ MM） patients. Methods Fifty MM patients were enrolled in the study,including 25 cases with low ALC level（〈 1. 46 × 109/L） and 25 cases with high ALC level（ ≥1. 46 × 109/L）.The association of ALC with clinical characteristics and prognosis of MM patients were analyzed. Results The peripheral blood white blood cell count（ WBC）,hemoglobin（ Hb） and platelet count（ Plt） were all lower in patients with low ALC level than those in patients with high ALC（ all P〈0. 05）. The levels of lactate dehydrogenase（ LDH） and β2-microglobulin（ β2-MG） were higher in patients with low ALC than those in patients with high ALC（ both P〈0. 05）. Thirteen cases（ 52. 0%） and 18 cases（ 72. 0%） achieved clinical remission in patients with low and high ALC levels,respectively（ P =0. 075）. The survival rate of low ALC patients was lower than that of high ALC patients（ 56. 0% vs 80. 0%,P〈0. 05）.Conclusion Newly diagnosed MM patients who have low ALC level tend to have a lower survival rate. The ALC level is closely related to multiple prognostic factors of MM and can be used as a marker for MM prognosis.