多发性骨髓瘤合并肺癌3例临床分析

Multiple myeloma with lung cancer:3 cases and literature review

目的分析多发性骨髓瘤(MM)合并肺癌的临床表现及治疗效果.方法回顾性分析首都医科大学石景山教学医院2017年1月至2018年12月收治的MM合并肺癌患者3例的临床资料.结果3例患者中男性2例,女性1例;平均年龄69.7岁;肺癌患者病理学类型均为腺癌,其中2例患者EGFR基因突变阳性,1例间变性淋巴瘤激酶(ALK)融合基因阳性.3例MM均为IgG-κ轻链型,分期为Ⅲ期A.MM患者采用的化疗方案均为PD方案4~6周期;1例患者因肺部感染死亡,1例患者MM完全缓解(CR),但是肺癌进展,1例患者MM非常好的部分缓解(VGPR),肺癌无复发征象.结论MM继发(或合并)第二肿瘤发病机制不明确,有待于进一步研究.

Objective To report 3 cases of multiple myeloma(MM)with lung cancer.Combined with litera-ture review to improve the understanding of MM with lung cancer.Methods The clinical characteristics,treatment and prognosis of 3 cases of MM with lung cancer in Shijingshan Teaching Hospital of Capital Medical University from January 2017 to December 2018 and the relevant literature were retrospectively reviewed.Results Among the 3 patients,2 cases were male and 1 case was female,with an average age of 69.7 years.The pathological type of lung cancer patients was adenocarcinoma,of which 2 cases were positive for EGFR gene mutation and 1 case was positive for ALK fusion gene.Three cases of multiple myeloma were all IgG-kappa light chain type,with stageⅢA.The chemotherapy regimens used in MM patients were all PD regimen 4-6 cycles;one patient died of pulmonary infec-tion,one patient had MM CR,but lung cancer progressed,one patient had MM very good partial remission(VGPR),and there was no recurrence of lung cancer.Conclusion The pathogenesis of second primary malignancy in MM is not clear,which needs further study.