初诊多发性骨髓瘤患者外周血ALC与临床特征及预后的关系
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摘要
目的探讨多发性骨髓瘤(multiple myeloma,MM)患者初诊外周血淋巴细胞绝对数(absolute lymphocyte count,ALC)与临床特征及预后的关系。方法回顾性分析初诊MM患者50例。根据中位ALC水平(1.46×109/L),将其分为ALC低水平组(ALC<1.46×109/L)和ALC高水平组(ALC≥1.46×109/L)各25例。根据临床资料及实验室检查结果分析ALC与初诊MM患者的临床特征和预后的关系。结果 ALC低水平组外周血白细胞(white blood cell,WBC)计数、血红蛋白(hemoglobin,Hb)和血小板(platelet,Plt)计数指标均低于ALC高水平组(均P<0.05)。ALC低水平组血清乳酸脱氢酶(lactate dehydrogenase,LDH)值和β2-微球蛋白(β2-microglobulin,β2-MG)指标均高于ALC高水平组(均P<0.05)。ALC低水平组和ALC高水平组治疗后缓解例数分别为13例(52.0%)和18例(72.0%),两组比较差异无统计学意义(P=0.075)。ALC低水平组患者生存率低于ALC高水平组(56.0%vs 80.0%,P<0.05)。结论初诊ALC水平低的患者生存率较低。ALC水平与MM的多个预后因素密切相关,可考虑作为MM判断预后的辅助指标。
Objective To investigate the association of peripheral blood lymphocyte count( ALC) with clinical features and prognosis in newly diagnosed multiple myeloma( MM) patients. Methods Fifty MM patients were enrolled in the study,including 25 cases with low ALC level( < 1. 46 × 109/L) and 25 cases with high ALC level( ≥1. 46 × 109/L).The association of ALC with clinical characteristics and prognosis of MM patients were analyzed. Results The peripheral blood white blood cell count( WBC),hemoglobin( Hb) and platelet count( Plt) were all lower in patients with low ALC level than those in patients with high ALC( all P < 0. 05). The levels of lactate dehydrogenase( LDH) and β2-microglobulin( β2-MG) were higher in patients with low ALC than those in patients with high ALC( both P < 0. 05). Thirteen cases( 52. 0%) and 18 cases( 72. 0%) achieved clinical remission in patients with low and high ALC levels,respectively( P =0. 075). The survival rate of low ALC patients was lower than that of high ALC patients( 56. 0% vs 80. 0%,P < 0. 05).Conclusion Newly diagnosed MM patients who have low ALC level tend to have a lower survival rate. The ALC level is closely related to multiple prognostic factors of MM and can be used as a marker for MM prognosis.
Objective To investigate the association of peripheral blood lymphocyte count( ALC) with clinical features and prognosis in newly diagnosed multiple myeloma( MM) patients. Methods Fifty MM patients were enrolled in the study,including 25 cases with low ALC level( < 1. 46 × 109/L) and 25 cases with high ALC level( ≥1. 46 × 109/L).The association of ALC with clinical characteristics and prognosis of MM patients were analyzed. Results The peripheral blood white blood cell count( WBC),hemoglobin( Hb) and platelet count( Plt) were all lower in patients with low ALC level than those in patients with high ALC( all P < 0. 05). The levels of lactate dehydrogenase( LDH) and β2-microglobulin( β2-MG) were higher in patients with low ALC than those in patients with high ALC( both P < 0. 05). Thirteen cases( 52. 0%) and 18 cases( 72. 0%) achieved clinical remission in patients with low and high ALC levels,respectively( P =0. 075). The survival rate of low ALC patients was lower than that of high ALC patients( 56. 0% vs 80. 0%,P < 0. 05).Conclusion Newly diagnosed MM patients who have low ALC level tend to have a lower survival rate. The ALC level is closely related to multiple prognostic factors of MM and can be used as a marker for MM prognosis.
引文
[1]刘志,黄竞,艾克拜尔·阿布都热衣木,等.淋巴细胞计数对维吾尔族初治多发性骨髓瘤患者生存的影响[J].中国临床研究,2016,29(6):768-770.
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[6]钟思思,李方林,刘爱飞,等.VAD方案和VD方案治疗初诊多发性骨髓瘤的效果比较[J].中国老年学杂志,2017,37(2):385-387.
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[8]邱荃,朱平,王茫桔,等.初诊多发性骨髓瘤患者CD56和CD19表达与染色体核型及预后的关系[J].中国实验血液学杂志,2016,24(4):1071-1078.
[9]Shin SJ,Roh J,Kim M,et al.Prognostic significance of absolute lymphocyte count/absolute monocyte count ratio at diagnosis in patients with multiple myeloma[J].Korean J Pathol,2013,47(6):526.
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[11]陈洁,王健民,杨建民,等.多发性骨髓瘤患者初发时淋巴细胞绝对数与预后关系分析[J].中华血液学杂志,2010,31(11):776-778.
[12]Jimenez-Zepeda VH,Reece DE,Suzanne T,et al.Absolute lymphocyte count as predictor of overall survival for patients with multiple myeloma treated with single autologous stem cell transplant[J].Korean J Pathol,2015,56(9):2668-2673.
[13]刘鹏杰,邓智勇,唐铭,等.89Sr Cl2治疗多发性骨髓瘤骨痛疗效分析[J].实用肿瘤杂志,2015,30(5):441-443.
[14]颜斌,魏锦,陈健,等.多发性骨髓瘤患者外周血T细胞亚群及细胞免疫功能研究[J].重庆医学,2013,42(11):1210-1212.
[2]王晓桃.多发性骨髓瘤诊治新进展[J].实用肿瘤杂志,2015,30(4):299-302.
[3]覃仕锋,刘莉.CIK细胞输入治疗对老年多发性骨髓瘤患者外周血免疫细胞水平影响及安全性分析[J].中国实验血液学杂志,2016,24(2):482-486.
[4]Suriu C,Akria L,Azoulay D,et al.Absolute lymphocyte count as a prognostic marker in newly diagnosed multiple myeloma patients[J].Int J Lab Hematol,2016,38(3):56-59.
[5]王攀峰,徐云,颜霜,等.血清游离轻链κ/λ比率在初诊多发性骨髓瘤患者诊断和预后中的作用[J].中华血液学杂志,2016,37(5):377-382.
[6]钟思思,李方林,刘爱飞,等.VAD方案和VD方案治疗初诊多发性骨髓瘤的效果比较[J].中国老年学杂志,2017,37(2):385-387.
[7]张津京,李艳.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[J].中国医科大学学报,2016,45(6):494-498.
[8]邱荃,朱平,王茫桔,等.初诊多发性骨髓瘤患者CD56和CD19表达与染色体核型及预后的关系[J].中国实验血液学杂志,2016,24(4):1071-1078.
[9]Shin SJ,Roh J,Kim M,et al.Prognostic significance of absolute lymphocyte count/absolute monocyte count ratio at diagnosis in patients with multiple myeloma[J].Korean J Pathol,2013,47(6):526.
[10]高顺姬,孙艳花,赵洪国.初诊多发性骨髓瘤176例临床特点及化疗效果观察[J].白血病·淋巴瘤,2016,25(9):539-542.
[11]陈洁,王健民,杨建民,等.多发性骨髓瘤患者初发时淋巴细胞绝对数与预后关系分析[J].中华血液学杂志,2010,31(11):776-778.
[12]Jimenez-Zepeda VH,Reece DE,Suzanne T,et al.Absolute lymphocyte count as predictor of overall survival for patients with multiple myeloma treated with single autologous stem cell transplant[J].Korean J Pathol,2015,56(9):2668-2673.
[13]刘鹏杰,邓智勇,唐铭,等.89Sr Cl2治疗多发性骨髓瘤骨痛疗效分析[J].实用肿瘤杂志,2015,30(5):441-443.
[14]颜斌,魏锦,陈健,等.多发性骨髓瘤患者外周血T细胞亚群及细胞免疫功能研究[J].重庆医学,2013,42(11):1210-1212.