| Background and purpose:Multiple myeloma(MM)is a malignant disease of clonal proliferation of plasma cells in the bone marrow.It is characterized by a series of clinical manifestations such as extensive bone destruction,infection,anemia,hypercalcemia,and renal insufficiency.About 10% of the blood system tumors and showed an increasing trend year by year.Heterogeneity is high,with a median survival of 3 to 4 years [1].The commonly used prognostic stratification systems are based on the biochemical indicators of patients and not include indicators of the characteristics of myeloma cells.Recent studies have shown that chromosomal abnormalities also have a high incidence in MM,and are mostly complex anomalies.The cytogenetic characteristics of MM can reflect the biological and cytological characteristics of tumors and provide important information for disease progression and prognosis.In this paper,we analyzed the factors that may affect the prognosis of myeloma patients,such as abnormal cytogenetic changes,clinical stages,and biochemical indexes,which are commonly found in 82 patients with MM.We plan to establish an accurate prognosis judgment system,evaluate the prognosis,and guide treatment.Methods:To collect the clinical features and laboratory indicators of 82 cases(76 cases available for analysis)diagnosed between January 2012 and December 2017 in Jilin University between January 2012 and December 2017.The patient's bone marrow specimens were routinely karyotyped using the R-banding technique.In situ fluorescence hybridization(FISH)was also performed.The single-factor,multiple,biochemical markers,clinical stages,and common cytogenetic changes were performed in MM patients.Statistical analysis of factors,and follow-up of patient survival data,analysis,cytogenetic changes on the treatment and prognosis.Results:1.Analysis of biochemical indicators: As of December 31,2017,53 cases of 82 patients were alive and 6 were lost to follow-up.Univariate statistical analysis showed that ESR,CRP,ALB,and LDH were poor prognostic factors of PFS(P values were 0.002,0.042,0.013,and 0.040,respectively).Multivariate analysis found that ESR,CRP,ALB,and LDH were independent prognostic factors for PFS.2.Clinical staging analysis: There was no significant difference in OS and PFS between stage III and stage III DS patients in stage DS(P=0.058,0.876,respectively).Stage III patients with ISS stage had better prognosis than stages I and II.The PFS was significantly shorter in patients,with a significant difference(P=0.023).3.Cytogenetic analysis: The abnormal ratio of FISH detection was 76.8%(47/76)in 76 patients,including 18.4%(14/76)in 1q21 amplification,13.1%(10/76)in P53 deletion,and 38.1% in IgH rearrangement.(29/76),13q14 is missing [del(13q14)] 30.2%(23/76).IgH rearrangement is a poor prognostic factor for OS,and P53 loss is a poor prognostic factor for PFS.Patients with karyotype karyotype had shorter PFS and OS than those with normal karyotype(P=0.023,0.048).Patients with complicated karyotype abnormalities had significantly shorter PFS and OS than patients with uncomplicated karyotypes.4.Efficacy analysis: The program containing bortezomib in patients with abnormal karyotype can prolong the patient's PFS and OS compared with the traditional treatment,but there is no significant difference(P values are 0.792 and 0.065,respectively).Conclusion:1.Single factor statistical analysis showed that ESR,CRP,ALB,and LDH were poor prognostic factors of PFS.Multivariate analysis suggested that hyperlipidemia,high CRP,low albumin,and high LDH were independent prognostic factors for PFS.2.The frequency of genetic abnormalities of multiple myeloma cells is high.Routine karyotype-associated FISH detection suggests that the cytogenetic features of MM have complex karyotypes,IgH rearrangement is a poor prognostic factor of OS,and P53 deficiency is a poor prognosis of PFS.factor.3.Bortezomib prolongs the survival of patients with abnormal karyotypes. |
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