沙利度胺、雷那度胺、硼替佐米治疗多发性骨髓瘤预后因素探析.docVIP

沙利度胺、雷那度胺、硼替佐米治疗多发性骨髓瘤的预后因素分析 　　[摘要]目的 探讨沙利度胺、雷那度胺、硼替佐米等治疗多发性骨髓瘤患者的总生存期（OS）及无进展生存（PFS），并分析预后相关因素。方法 回顾性分析2010年1月～2015年1月在我院经沙利度胺、雷那度胺、硼替佐米治疗的42例多发性骨髓瘤患者病历资料。对选取的参数进行单因素分析，采用Cox模型行单因素分析，对有统计学意义的参数进行多因素回归分析，并构建生存曲线。结果 全组中位生存期43.36个月，2年OS率为76.19%，3年OS率为42.86%。单因素分析中，患者的年龄、血肌酐、LDH、β2-MG、ISS分期、治疗后血清游离轻链比值正常化与否、疗效与OS相关，年龄、疗效与PFS相关。结论 多发性骨髓瘤治疗后血清游离轻链比值及治疗深度与患者OS相关，沙利度胺、雷那度胺、硼替佐米能够明显改善患者的OS [关键词]多发性骨髓瘤；预后；单因素分析；多因素分析；Kaplan-Meier评估 [中图分类号] R733.3 [文献标识码] A [文章编号] 1674-4721（2016）10（a）-0101-04 [Abstract]Objective To explore overall survival （OS） and progression free survival （PFS） Thalidomide，Lenalidomide and Bortezomib in the treatment of patients with multiple myeloma and analyze prognosis related factors.Methods A retrospective analysis was made on 42 cases of multiple myeloma in our hospital from January 2010 to January 2015.The parameters were analyzed by single factor，the single factor analysis was carried out by Cox model，and the parameters of statistical significance were analyzed by multiple factors regression analysis，and the survival curve was constructed.Results Median survival time was 43.36 months，OS rate for 2 years was 76.19%，with 42.86% for 3 years.In single factor analysis，age，serum creatinine，LDH， β2-MG，ISS stage，serum free light chain ratio of normal or not after treatment and effect were associated with OS，age and effect were associated with PFS.Conclusion Serum free light chain ratio and the depth of treatment are associated with OS after treatment for patients with multiple myeloma，Thalidomide，Lenalidomide and Bortezomib treatment can significantly improve OS of patients. [Key words]Multiple myeloma；Prognosis；Single factor analysis；Multiple factor analysis；Kaplan-Meier evaluation 作为初始治疗及治疗复发疾病，多发性骨髓瘤（multiple myeloma，MM）是一种典型的对化疗药物敏感的疾病，不幸的是，反应短暂的MM仍被认为是现阶段治疗手段无法治愈的疾病。但是，近年来，由于新药诸如沙利度胺、雷利度胺以及硼替佐米的应用，MM的治疗得到了迅速的发展[1]。在此笔者回顾性研究了新型药物对MM的治疗反应及临床特征对其预后的影响 1资料与方法 1.1一般资料 2010年1月～2015年1月我科共接诊了80例MM患者，诊断依据张之南等主编的《血液病诊断及疗效标准》及MM肿瘤临床指南[2]。其中