Clinical Analysis Of Patients With Light-chain MultiplMyeloma

Objective: To observation and summarizes light chain multiple myeloma cilinicaland for the light-chain multiple bone myeloid tumor diagnosis and treatment based multiple on clinical evidence.Methods: To collected 19 cases of light-chain multiple myeloma patients'clinical datas who treated in Dalian Medical University Second Affiliated Hospital during 1990-2006, and analyzed retrospectively. To elect the same period 44 patients admitted to the MM-IgG and IgA type in 23 cases of MM as the clinical datd of the control group study.Results:(1)19 cases of light-chain multiple myeloma patients were 13 men and six women, men accounted for 68.4%.From age 35 ~ 74 years,the meadian age 64 years, 50 of 15 cases over the age of 79 accounted for.onset time from diagnosis to a month to 2.5 years, with an average of 9.0 months. Phase I of 5 patients , Stage II 9 patients, with stage III 5 patients.(2) 19 cases of light-chain multiple myeloma patients with 2-microglobulin (2-microglobulin) in 9.95±1.45mg/L compared with the control group (3.82 MM-IgG±0.95mg/L, IgA MM 3.73±0.75 mg/L) with significant differences.(3) 19 cases of light-chain multiple myeloma patients with renal dysfunction in 10 patients (K/DOQI 2 3 K/DOQ I three K/DOQI 5 4 2 cases) accounted for 52.6%.and the control group(IgG MM-12 accounted for 27.3%, IgA MM six cases accounted for 26.1%) compared with significant differences.(4) MP and VBMCP (M2) in the treatment of light chain multiplemyeloma patients in 7 cases, complete remission 1 partial response in 2 (42.3% efficiency) invalid 4; 2 cases of renal dysfunction heavier than before treatment (1 Ccr by 195umol/L to 225um pair. Another 1 Ccr by 246umol/L to 445umol/L) chemotherapy for a few cases of both 28.6%; VAD program for light chain multiple myeloma patients in 12 cases, 4 cases of complete remission. partial response in 5 patients (75% efficiency), 3 cases. Renal function and chemotherapy earlier : improve 7 (Ccr decline 45umol/L L±15) accounted for 58.3% No change in 3 cases progress in two cases (one of which was from 156umol/L Ccr to 215umol/L. Another 1 Ccr by 346umol/L to 457umol/L) chemotherapy for a few cases of 16.7%.Conclusion:(1)MM light chain-2-microglobulin levels higher than the MM-IgG and IgA MM prominent.(2)Light-chain MM renal dysfunction than-IgG and IgA MM MM was particularly prevalent.(3)Treatment of MM-light chain to VAD choice programs, both efficient and renal toxicity were better than MP and VBMCP (M2) program.