多发性骨髓瘤以侵犯颅脑及胸膜为复发表现的临床研究

Clinical Study of Recurrent Multiple Myeloma with Invasion into the Brain and Pleura

目的探讨以侵犯颅脑及胸膜为髓外复发表现的多发性骨髓瘤的临床特点、治疗反应及预后。方法回顾性分析1例经病理确诊为多发性骨髓瘤复发病例的临床资料,并复习相关文献以提高多发性骨髓瘤以侵犯颅脑及胸膜为复发表现的认识。结果该患者经过以硼替佐米、来那度胺等标准方案治疗后,病情稳定后半年出现以侵犯颅脑及胸膜复发为首发表现,骨髓瘤细胞广泛侵及椎体,胸腔积液及脑脊液病理为骨髓瘤细胞,对各种治疗方案耐药最终死亡。结论多发性骨髓瘤临床表现复杂多样,其中以颅脑、胸膜为髓外复发表现较为少见,预后极差。

Objective To study the clinical characteristic,therapeutic response and prognosis of recurrent multiple myeloma with invasion into the brain and pleura. Methods Retrospective analysis of clinical data of 1 case of pathologically diagnosed multiple myeloma relapse cases were conducted,and related literature were reviewed. Results The patient received bortezomib,lenalidomide standard treatment and was stable for 6 months,then brain and pleural recurrence had its first manifestation.Myeloma cell invasion reached vertebral,pleural fluid and cerebrospinal fluid widely,various kinds of treatment plans ultimately lead to death. Conclusion Clinical manifestations of multiple myeloma are complicated,with scarce invasion into the brain and pleura,and the prognosis is poor.