R-ISS分期联合“多重打击”在多发性骨髓瘤患者中预后的预测价值

Prognostic Value of R-ISS Staging Combined with"Multiple-Hits"in Patients with Multiple Myeloma

目的:分析R-ISS分期联合“多重打击”对多发性骨髓瘤(MM)患者的预后判断价值及不同“多重打击”组合对患者预后的影响。方法:选取并回顾性分析2013年4月至2019年10月新疆维吾尔自治区人民医院血液科收治的初诊MM患者220例,所有患者均经过FISH检测。比较R-ISS分期联合“多重打击”以及不同“多重打击”组合对预后的影响。结果:R-ISSⅡ和Ⅲ期中,“多重打击”患者的中位无进展生存(PFS)时间、总生存(OS)时间和持续缓解(DOR)时间均短于无高危细胞遗传学异常(HRCA)和仅包含一种HRCA的患者(P<0.05),而TTR(达到反应时间)明显延长(P<0.05)。不同“多重打击”组合中,1q21+合并del(17p)、1q21+合并t(14;16)及1q21+合并t(4;14)3种“双打击”组合之间,1q21+合并del(17p)患者的预后最差。结论:不同“多重打击”组合的患者预后不同。R-ISS分期与“多重打击”相结合更有利于精准判断MM患者预后。

Objective:To analyze the prognostic value of R-ISS staging combined with"Multiple-Hits"in patients with multiple myeloma(MM),and to detected the effect of different"Multiple-Hits"combinations to the prognosis of the patients.Methods:The 220 MM patients treated in the hematology department of People's Hospital of Xinjiang Uygur Autonomous Region from April 2013 to October 2019 were enrolled and retrospective analyzed.All the patients were detected by FISH.The effects of R-ISS staging combined with"Multiple-Hits"and different"Multiple-Hits"combinations to the prognosis of the patients were compared.Results:For the patients at R-ISS stageⅡandⅢ,the median progression-free survival(PFS)time,overall survival(OS)time and duration of response(DOR)time in"Multiple-Hits"patients were all shorter than those without high-risk cytogenetic abnormality(HRCA)and those with only one type of HRCA(P<0.05),while the TTR(time to response)was significantly prolonged(P<0.05).For the prognosis of the patients among the three different"Multiple-Hits"combinations(1q21+combined with del(17p),1q21+combined with t(14;16)and combined 1q21+combined with t(4;14)),1q21+combined with del(17p)showed the worst prognosis.Conclusion;The patients with Different"Multiple-Hits"combinations shows different prognosis.The R-ISS staging combination with"Multiple-Hits"is more conducive to accurately judging the prognosis of MM patients.