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透析依赖与多发性骨髓瘤的预后不佳有关:多中心回顾性队列研究
Ji-Nuo Wang1,2, Chenyun Wang3, Jinping Ying4
1Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou, Zhejiang, China.
透析依赖多发性骨髓瘤 (MM) 患者的治疗结果不佳,但实现透析独立显著改善了生存率. 与更好的预后相关的因素包括VGPR,daratumumab和减少的无血清轻链.
科学领域:
- 血液学
- 肝脏病学
- 癌症学
背景情况:
- 多发性骨髓瘤 (MM) 与功能障碍 (RI),尤其是需要透析的病例,往往表现不佳.
- 尽管有针对性的治疗进展,对透析依赖的MM和透析独立的因素的预后仍然不清楚.
研究的目的:
- 分析中国透析依赖的MM患者的临床特征和治疗结果.
- 确定影响该群体透析独立性和长期生存的因素.
主要方法:
- 在122名慢性血液透析MM患者中进行的一项多中心,回顾性,实验性队列研究.
- 用物流回归和卡普兰-梅尔/ 考克斯模型来分析透析独立性和生存率.
主要成果:
- 在27%的患者中实现了透析独立;这些患者的无进展生存期 (PFS) 和整体生存期 (OS) 显著延长.
- 与透析独立相关的因素包括非常好的部分反应 (VGPR),基于达拉图巴的治疗方案,显著的无血清轻链减少和65岁以下的年龄.
- 在整个队列中,PFS的中位数为14. 4个月,OS的中位数为27. 4个月.
结论:
- 透析依赖性MM患者的预后即使使用新疗法也很差.
- 在患有功能障碍的MM患者中,实现透析独立是改善生存的关键因素.
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