初诊多发性骨髓瘤血小板减少患者临床特征及预后分析

Analysis of clinical characteristics and prognosis of patients with newly diagnosed multiple myeloma with thrombocytopenia

目的:探讨血小板减少的初诊多发性骨髓瘤(newly diagnosed multiple myeloma,NDMM)患者的临床特征及与预后。方法:回顾性分析2012年1月至2021年12月山西医科大学第二医院收治的529例NDMM患者临床资料。根据其血小板计数水平将患者分为血小板减少组和血小板正常组。结果:本研究共纳入529例NDMM患者,血小板减少组108例,占20.42%(108/529)。血小板减少组中位无进展生存期(median progression-free survival,m PFS)30.64(95%CI:23.43~37.85)个月短于血小板正常组41.39(95%CI:37.37~45.39)个月(P=0.002)。血小板减少组中位总生存期(median overall survival,mOS)40.59(95%CI:30.61~50.57)个月短于血小板正常组60.92(95%CI:54.54~67.29)个月(P<0.001)。多因素Cox回归分析显示血小板减少是影响总生存率(overall survival,OS)的独立预后因素(HR=1.238,95%CI:1.16~1.952,P=0.03)。结论:血小板减少的NDMM患者预后差于血小板正常的患者,血小板减少可作为NDMM的不良预后参数。

Objective:To investigate the clinical characteristics and prognosis of patients with newly diagnosed multiple myeloma(NDMM)with thrombocytopenia.Methods:Clinical data of 529 patients with NDMM admitted to The Second Hospital of Shanxi Medical University between January 2012 and December 2021 were retrospectively analyzed.The patients were categorized into thrombocytopenia and normal platelet count groups based on their platelet count levels.Results:A total of 529 patients with NDMM were included in this study,with 108(20.42%)patients in the thrombocytopenia group.The median progression-free survival(mPFS)was 30.64 months(95%confidence interval[CI]:23.43-37.85)in the thrombocytopenia group,which was shorter than that in the normal platelet count group(41.39 months[95%CI:37.37-45.39],P=0.002).The median overall survival(mOS)was 40.59 months(95%CI:30.61-50.57)in the thrombocytopenia group,which was shorter than that in the normal platelet count group(60.92 months[95%CI:54.54-67.29],P<0.001).Multivariate Cox regression analysis identified thrombocytopenia as a risk factor for OS in patients with NDMM(HR=1.238[95%CI:1.16-1.952],P=0.03).Conclusions:The prognosis of patients with NDMM with thrombocytopenia was worse than that of patients with NDMM who had normal platelet levels.Thrombocytopenia may serve as a poor prognostic indicator for NDMM.