多发性骨髓瘤合并骨髓纤维化患者的临床特征及预后研究

Clinical Characteristics and Prognosis of Multiple Myeloma Patients with Myelofibrosis

目的:探讨多发性骨髓瘤合并骨髓纤维化患者的临床特征及预后。方法:回顾性分析2016年1月1日至2020年6月31日本院血液内科收治的多发性骨髓瘤患者263例(其中92例患者合并骨髓纤维化)的临床资料,并将患者分为合并组及未合并组。观察合并组及未合并组患者的MM分期、MM分型、细胞遗传学特征、疗效,并分析合并组的疗效与骨髓纤维化变化的相关性。结果:多发性骨髓瘤合并骨髓纤维化患者的MM分期、分型与未合并骨髓纤维化组患者比较差异无统计学意义(P>0.05);合并骨髓纤维化组FISH结果阳性率明显高于未合并组,且与1q21扩增、D13S319缺失、IgH断裂有明显相关性(P<0.05);治疗后未合并骨髓纤维化组的有效率明显高于合并组,且合并组治疗有效患者的纤维化程度明显下降。结论:多发性骨髓瘤合并骨髓纤维化患者的生存率较未合并骨髓纤维化患者短,整体预后不佳。

Objective:To investigate the clinical characteristics and prognosis of multiple myeloma patients with myelofibrosis.Methods:The clinical data of 263 patients with multiple myeloma(including 92 patients with myelofibrosis) treated in the department of hematology of our hospital from January 1,2016 to June 31, 2020 were collected and retrospectively analyzed,the patients were divided into combined group and uncombined group.The MM stage,MM type,genetic characteristics and therapeutic effect of the patients in combined group and uncombined group were observed,and the relationship between the curative effect and the degree of myelofibrosis change of the patients in combined group was analyzed.Results: There was no statistically difference in the MM staging and classification between multiple myeloma patients with or without myelofibrosis(P>0.05).The positive rate of FISH results of the patients in combined group was significantly higher than those in uncombined group,and was significantly correlated to1 q21 amplification,D13 S319 deletion,and IgH breakage(P <0.05).After treatment,the effective rate of the patients in uncombined group was significantly higher than those in combined group, and the degree of fibrosis in the effective patients in combined group was significantly reduced.Conclusion:The survival rate of the patients with multiple myeloma complicated with myelofibrosis is shorter than that of the patients without myelofibrosis, and the overall prognosis is poor.