由HB、PLT和MCV组成的造血评分系统与多发性骨髓瘤患者预后及疗效相关性的研究

The Relationship between Hematopoietic Scoring System Composed of HB,PLT and MCV and Prognosis and Curative Effect of Multiple Myeloma Patients

目的:分析由血红蛋白(HB)、血小板数(PLT)、平均红细胞体积(MCV)组成的造血评分系统在MM患者中的预后价值及与疗效的相关性。方法:收集本院2014年5月至2019年12月172例以硼替佐米为一线方案治疗的初诊MM患者的临床资料,引入3个变量(HB≤100 g/L,PLT≤150×109/L,MCV≥96 fl),给每个变量分配一个1的分数,将患者分为4组(第1、2、3、4组分别为0、1、2和3分),分析4组患者的临床特征及预后;对治疗3-4个疗程后的患者进行初次疗效评价,比较4组患者的疗效差异。结果:第1、2、3和4组患者的中位OS时间分别为27.0、22.5、20.7和18.1个月,中位PFS分别为23.0、19.0、18.0和14.0个月,评分低组的患者OS、PFS明显优于评分高组,且差异有统计学意义(P=0.045,P=0.048);4组患者治疗3-4个疗程后,疗效并无显著性差异(P>0.05)。结论:该造血评分系统能够初步预测新诊断MM患者的整体生存,但不同评分组间在初次疗效评价中未发现明显差异。

Objective: To investigate the prognostic value of hemopoietic scoring system composed of hemoglobin(HB), platelet count(PLT) and mean corpuscular volume(MCV) in MM patients and its correlation with curative effect. Methods: The clinical data of 172 newly diagnosed MM patients treated by bortezomib as the first-line regimen in our hospital from May 2014 to December 2019 were collected, three variables(HB ≤100 g/L, PLT ≤150×109/L, MCV ≥96 fl) were introduced, each variable was distributed 1 score, the patients were divided into four groups(0, 1, 2 and 3 points in group 1, 2, 3 and 4, respectively), and the clinical characteristics and prognosis of the patients in the four groups were analyzed. The initial efficacy evaluation after 3-4 courses of treatment was carried out, and the curative effect of the patients in the different hematopoiesis score groups were compared. Results: The median OS time of the patients in group 1, 2, 3 and 4 was 27.0, 22.5, 20.7 and 18.1 months, while the median PFS time were 23.0, 19.0, 18.0 and 14.0 months, respectively. The OS and PFS of the patients in low score group were significantly better than those in high score group(P=0.045, P=0.048). There was no significant difference in the curative effect of the patients treated by bortezomib after 3-4 courses(P>0.05). Conclusion: Hematopoiesis score can preliminarily predict the overall survival of newly diagnosed MM patients, but there is no significant difference between different scoring groups in the initial curative effect.