红细胞分布宽度在多发性骨髓瘤患者中预后的相关性研究

doi:10.3969/j.issn.1004-583X.2019.10.011

临床荟萃

红细胞分布宽度在多发性骨髓瘤患者中预后的相关性研究

苏州大学附属第三医院血液科，江苏常州 213003

出版日期:2019-10-20 发布日期:2019-12-09
通讯作者: 林艳, Email: thelmalinyan@163.com

Correlation between red cell distribution width and prognosis in patients with multiple myeloma

Department of Hematology, the Third Affiliated Hospital of Soochow University, Changzhou 213003, China

Online:2019-10-20 Published:2019-12-09
Contact: Corresponding author: Lin Yan, Email: thelmalinyan@163.com

摘要/Abstract

摘要： 目的探讨初诊时基线红细胞分布宽度（red cell distribution width，RDW）水平在多发性骨髓瘤（multiple myeloma，MM）中的预后价值。方法回顾性分析279例在我院诊断的MM患者，分别检测一线治疗前的1周内、确认获得治疗反应的1周内及确认疾病进展的1周内的RDW水平，将患者分为RDW正常组（≤15.5%，n=133）和升高组（>15.5%，n=146），同时收集患者的治疗反应与生存资料等临床数据，采用Cox比例风险模型评估RDW的预后价值。结果在获得较好缓解的患者中RDW的水平较基线有明显的变化（P=0.0491），较疾病进展时同样有明显变化（P=0.0314）。在RDW升高组和正常组中位的总生存（overall survival，OS）、无进展生存（progression free survival，PFS）分别为22个月和46个月（P<0.01），12个月和30个月（P<0.01）。多因素分析显示RDW是OS（P=0.0010，HR=2.248，95%CI:1.3683.694）和PFS（P=0.0000，HR=2.797，95%CI:1.8424.248）的独立危险因素。结论 MM患者初诊时RDW水平升高提示不良的临床预后。

关键词: 多发性骨髓瘤, 红细胞分布宽度, 总生存, 无病进展生存, 预后

Abstract: Objective To investigate the prognostic value of baseline red cell distribution width (RDW) level in patients with multiple myeloma (MM) at the first visit. Methods A total of 279 MM patients were included and divided into high RDW group (>15.5%, n=146) and normal RDW group (≤15.5%, n=133). RDW levels were detected on the latest day within 1 week before the frontline treatment, within 1 week after patients had good treatment response confirmed, and within 1 week after disease progression confirmed. Clinical data such as treatment response and survival data were collected, and the prognostic value of RDW was evaluated with Cox proportional hazards models.Results There were significant changes of RDW levels between the time points of diagnosis and good treatment response (P=0.0491), and the time points of obtaining good treatment response and disease progression (P=0.0314), when estimated the series of samples of the same individual patient. It was indicated that RDW might act as a biomarker for disease progression surveillance. The median overall survival (OS) times of high RDW and normal RDW groups were 22 months and 46 months, respectively (P<0.01). And the median progression free survival (PFS) times of high RDW and normal RDW groups were 12 months and 30 months, respectively (P<0.01). Multivariate analysis showed that RDW level was an independent risk factor for OS (P=0.0010, HR=2.248, 95%CI: 1.3683.694) and PFS (P=0.0000, HR=2.797, 95%CI: 1.8424.248). Conclusion The elevated RDW level at the first visit predicted adverse clinical outcomes in MM patients.

Key words: multiple myeloma, red cell distribution width, overall survival, progressionfree survival, prognosis

李枫，王飞，岳延华，郭嫣婷，董伟民，林艳. 红细胞分布宽度在多发性骨髓瘤患者中预后的相关性研究[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2019.10.011.

Li Feng, Wang Fei, Yue Yanhua, Guo Yanting, Dong Weimin, Lin Yan. Correlation between red cell distribution width and prognosis in patients with multiple myeloma[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2019.10.011.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2019.10.011

https://huicui.hebmu.edu.cn/CN/Y2019/V34/I10/915

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红细胞分布宽度在多发性骨髓瘤患者中预后的相关性研究

Correlation between red cell distribution width and prognosis in patients with multiple myeloma

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