中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (6): 494–498.doi: 10.12007/j.issn.0258-4646.2016.06.004

• 论著 • 上一篇    下一篇

初诊多发性骨髓瘤合并肾功能不全患者的临床特点和疗效分析

张津京,李艳   

  1. 中国医科大学附属第一医院血液科,沈阳 110001
  • 收稿日期:2016-01-11 出版日期:2016-06-28 发布日期:2016-05-30
  • 通讯作者: 李艳 E-mail:liyan@medmail.com.cn
  • 作者简介:张津京(1987 -),女,医师,硕士.
  • 基金资助:
    辽宁省科学技术计划(2013225079)

Clinical Characteristics and Efficacy Analysis of Newly Diagnosed Multiple Myeloma Patients with Renal Insufficiency

ZHANG Jinjing,LI Yan   

  1. Department of Hematology,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2016-01-11 Online:2016-06-28 Published:2016-05-30

摘要: 目的 分析初诊多发性骨髓瘤合并肾功能不全患者的临床特点,评价含硼替佐米的治疗方案对于合并肾功能不全的多发性骨髓瘤患者的疗效。方法 对我院 2009 年 11 月至 2015 年 9 月收治的 156 例初诊多发性骨髓瘤患者的临床资料进行回顾 性分析。结果 156 例初诊多发性骨髓瘤患者中,肾功能不全[GFR<60 mL(/ min?1.73 m2)]的发生率为 36.5%(57/156)。与肾功 能正常组患者相比,肾功能不全组的患者贫血更严重,高钙血症、高尿酸血症、ISS Ⅲ期、IgD 型和轻链型的发生率明显增高,而 2 组患者在性别、年龄、白蛋白、乳酸脱氢酶、DS Ⅲ期方面无统计学差异。在 51 例可评价疗效的合并肾功能不全的多发性骨髓瘤 患者中,硼替佐米组的总反应率(完全缓解+非常好的部分缓解+部分缓解)明显优于非硼替佐米组(分别为 83.33%和 57.14%, P = 0.039),并且硼替佐米组的完全缓解率明显高于非硼替佐米组(分别为 60.00%和 19.04%,P = 0.004);肾功能不全对治疗的 总反应率(肾功能完全反应+肾功能部分反应+肾功能微小反应)为 78.43%,其中硼替佐米组的总反应率高于非硼替佐米组(分别为 83.33%和 71.43%),但差异无统计学意义(P = 0.327)。结论 合并肾功能不全的多发性骨髓瘤与肾功能正常的多发性 骨髓瘤具有不同的临床特点,病程相对严重,应用含硼替佐米的治疗方案可提高多发性骨髓瘤的疗效,可以作为初诊多发性骨 髓瘤合并肾功能不全患者的优先治疗方案。

关键词: 多发性骨髓瘤, 肾功能不全, 硼替佐米

Abstract: Objective To study the clinical characteristics of newly diagnosed multiple myeloma patients,and to evaluate the efficiency of bortezomib contained regimens in multiple myeloma with renal insufficiency. Methods A total of 156 newly-diagnosed patients admitted to our hospital between November 2009 and September 2015 were retrospectively studied. Results Among the 156 patients with multiple myeloma,renal insufficiency was present in 57(36.5%)and correlated with adverse clinical features such as severe anemia,hypercalcemia,hyperuricemic,and advanecd ISS stage. The types of IgD and light chain were more liable to develop renal insufficiency. The overall remission rate was 83.33% for bortezomib contained regimens group and 57.14% for non - bortezomib contained regimens group,and the difference was statistically significant(P = 0.039),as well as the complete remission rates between the two groups(P = 0.004). Out of the 51 patients who were evaluable for renal response,the overall remission rate was 78.43%,there was no statistical difference between the two groups(83.33% vs 71.43%,P = 0.327). Conclusion Multiple myeloma patients with renal insufficiency had different clinical characteristics from those without renal insufficiency,whose disease course were relatively worse. Bortezomib contained regimens could improve the therapeutic effect,which might be a prior choice for newly multiple myeloma patients with renal insufficiency.

Key words: multiple myeloma, renal insufficiency, bortezomib

中图分类号: 

  • R733.3
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