免疫表型对以硼替佐米为主方案治疗的多发性骨髓瘤患者预后的影响

Effect of immunophenotyping on prognosis of multiple myeloma patients treated with bortezomib asmain treatment

目的探讨免疫表型对以硼替佐米为主方案治疗的多发性骨髓瘤（MM）患者预后的影响。方法回顾性分析2012年1月至2017年1月青岛大学附属医院血液内科收治的76例MM患者，均接受以硼替佐米为主方案治疗。分析比较CD45、CD56表达以及其他因素对患者无进展生存（PFS）和总生存（OS）的影响。结果单因素分析结果表明，CD45阳性和阴性MM患者的中位PFS时间分别为12、19个月，中位OS时间分别为19、23个月，差异均有统计学意义（P〈0．001和P=0．001）。血红蛋白〈100g／L和≥100g／L患者的中位PFS时间分别为14、21个月，中位0s时间分别为16、25个月，差异均有统计学意义（P=0．014和P=0．026）。清蛋白〈35g／L和≥35g／L患者的中位PFS时间分别为13、18个月，中位OS时间分别为14、24个月，差异均有统计学意义（P=0．004和P=0．008）。女性MM患者的中位PFS时间和中位OS时间均短于男性患者（13个月比19个月，P=0．008；16个月比25个月，P=0．008）。多因素分析提示女性和CD45阳性是影响MM患者PFS和OS的独立不良预后因素（均P〈0．05）。结论CD45阳性及女性是以硼替佐米为主要方案治疗的MM患者的重要预后因素。

Objective To investigate the effect of immunophenotyping on prognosis of multiple myeloma （MM） patients treated with bortezomib regimen as main treatment. Methods Seventy-six MM patients in the Department of Hematology in the Affiliated Hospital of Qingdao University from January 2012 to January 2017 were retrospectively analyzed. The effects of the expressions of CD45, CD56 and other factors on progression free survival （PFS） and overall survival （OS） in MM patients treated with bortezomib-containing regimen were also analyzed. Results Univariate analysis showed that statistical differences of the median PFS （12 months vs. 19 months, P 〈 0.001） and median OS （19 months vs. 23 months, P = 0.001） were significant in the group of CD45 positive and negative of MM patients; the median PFS （14 months vs. 21 months, P = 0.014） and median OS （16 months vs. 25 months, P = 0.026） for MM patients with hemoglobin （Hb） 〈 100 g/L and Hb ~〉 100 g/L were statistically significant; the median PFS （13 months vs. 18 months, P = 0.004） and median OS （14 months vs. 24 months, P = 0.008） for MM patients with albumin （ALB） 〈 35 g/L and ALB I〉 35 g/L were statistically significant. The median PFS time and the median OS time in female MM patients were shorter than those in male MM patients （13 months vs. 19 months, P = 0.008; 16 months vs. 25 months, P = 0.008）. Multivariate analysis showed that female and CD45 positive were the independent poor prognostic factors for PFS and OS in MM patients （P 〈 0.05）. Conclusion CD45 positive and female are important prognostic factors for MM patients treated with bortezomib regimen as main treatment.