输血对首次诊断多发性骨髓瘤患者预后的影响

Prognosis effect of blood transfusion on multiple myeloma patients

目的:研究输血对初诊多发性骨髓瘤(MM)患者预后的影响。方法:采用匹配病例对照研究方法,将2012-06-2016-12首次诊断的84例MM患者根据是否输血分为输血组(42例)和非输血组(42例)。观察各组总生存率(OS)及无进展生存率(PFS)。结果:输血患者的血红蛋白水平比非输血组患者低。输血组患者硼替佐米的使用率更高。单因素分析中采取输血的患者PFS更低;年龄、ISS分期、血小板水平、血红蛋白水平、血清肌酐水平、血清β2-MG、血清钙和沙利度胺药物的使用是OS和PFS的共同影响因素。采用多变量分析,高龄(≥60),高血清钙(≥2.75mmol/L)是影响MM患者OS的危险因素,高血小板水平(≥100×109/L)和沙利度胺药物的使用是OS的保护因素。Ig分型和沙利度胺应用是MM患者PFS的独立预后因素。输血不是MM患者OS和PFS的独立预后因素。结论:沙利度胺药物能够有效提高患者的OS和PFS。输血不影响MM患者的PFS以及OS,不是MM患者预后的危险因素。

Objective：To analysis the prognosis effect of blood transfusion on multiple myeloma（MM）patients.Method：A case-control study of 84 MM patients who were diagnosed first in our hospital from June 2012 to December 2016 were divided into transfusion group（n=42）and non-transfusion group（n=42）.The overall survival（OS）and progression-free survival（PFS）were observed.Result：Hemoglobin levels in patients with transfusion were lower than that in non-transfusion patients.The percentage of bortezomib using was higher in transfusion group.The age,ISS stage,platelet level,hemoglobin level,serum creatinine level,serumβ2-MG,serum calcium and thalidomide were the common factors of OS and PFS in univariate analysis.In multivariate analysis,older age（≥60）and higher serum calcium（≥2.75 mmol/L）were the risk factors for OS in MM patients.Higher platelet levels（≥100×10^9/L）and use of thalidomide were protection factors for OS.Ig isotype and thalidomide were the independent prognostic factors for PFS in MM patients.Blood transfusion was not an independent prognostic factor for OS and PFS in MM patients.Conclusion：Thalidomide could effectively improve OS and PFS in MM patients.Blood transfusion would have no effect on PFS and OS of MM patients,and not be the risk factor for the prognosis of MM patients.