多发性骨髓瘤预后因素风险权重的年龄相关变化
Chenxing Du1, Lingna Li1, Huishou Fan1
1State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, People's Republic of China.
Hematology (Amsterdam, Netherlands)
|September 19, 2023
概括
老年多发性骨髓瘤患者面临更糟糕的结果,年龄影响的预后因素如ISS. 在71岁以上的患者中,博尔特佐米布的益处较小,这凸显了对量身定制治疗的需要.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 老年医学 老年医学
背景情况:
- 多发性骨髓瘤 (MM) 是一种异质的血细胞恶性瘤,主要影响老年人.
- 目前的预后分期系统通常依赖于年轻,更健康的人群的临床试验数据,可能会误导老年MM患者的风险.
- 生物化学和细胞遗传因素对老年MM患者预后的影响仍然不完全理解.
研究的目的:
- 研究多发性骨髓瘤的预后因素及其风险权重如何随着年龄的增长而变化.
- 为了比较波尔特佐米布与基于thalidomide的疗法在MM的不同年龄组之间的有效性.
- 确定多发性骨髓瘤老年患者的具体挑战和需求.
主要方法:
- 在2008年1月至2019年12月期间治疗的1125名新诊断的多发性骨髓瘤患者的回顾性分析.
- 患者接受了基于博特佐米布或沙利多米德的诱导和维持疗法,并考虑了血液造血干细胞移植的资格.
- 使用Stata/MP 16.0和SPSS 26.0.0进行的统计分析.
主要成果:
- 年龄的增加与ISS第3阶段的更高率相关,性能状态≥2,和细胞遗传异常的增加.
- 国际分期系统 (ISS) 在老年患者 (≥71岁) 中显示预后值降低.
- 细胞遗传异常始终预测年轻和老年MM患者的存活率较低,这些患者通常与年轻同行相比有较差的结果.
- 虽然大多数患者受益于博尔特佐米布而不是thalidomide,但这种优势在71岁及以上的患者中减少.
结论:
- 在老年多发性骨髓瘤患者 (≥71岁) 中,ISS的预后意义可能会减少.
- 年龄较大的MM患者经历的结果较差,需要有效且毒性较低的治疗方法.
- 脆弱的身体状况成为管理老年MM患者的关键因素,可能会掩盖瘤负担.
- 进一步的研究对于为老年人和脆弱的多发性骨髓瘤患者群体开发最佳的治疗策略至关重要.
关键词:
关于 ECOG 绩效状态的情况国际空间站 (ISS) 的分阶段化多发性骨髓瘤是一种多发性骨髓瘤.博尔特佐米布 (Bortezomib) 是一种药物.细胞遗传学 细胞遗传学老年病的治疗方法这是一个高风险的高风险项目.预后 预后 预后更多相关视频
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