菲律宾一家三级医院成年多发性骨髓瘤患者的临床概况和生存结果

Jeremiah R. Vallente, Carlo Francisco N. Cortez, Ma. Angelina L. Mirasol
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摘要

目的菲律宾人口在目前可获得的多发性骨髓瘤(MM)文献中代表性不足。在此,我们旨在确定菲律宾成年MM患者的临床特征、治疗和结局。材料和方法回顾性分析2016年至2019年在我们机构就诊的74例MM患者的记录。结果诊断时中位年龄54岁,以40 ~ 65岁年龄组居多。诊断时,36例(64.3%)患者出现贫血(血红蛋白≥100 g/L),而高钙血症(钙≥2.75 mmol/L)和氮血症(肌酐≥177 umol/L)分别仅9例(20.0%)和18例(34.0%)。54例(84.4%)患者使用新型药物(硼替佐米、沙利度胺和来那度胺)进行一线治疗。总有效率为70.0%,中位总生存期(OS)为60个月。在单变量分析中,只有血红蛋白和血清白蛋白水平影响生存。结论除了诊断年龄有年轻化趋势外,菲律宾MM没有独特的临床特征。较长的生存期可能反映了近十年来新药的可用性,但需要更大规模的研究来调查几种临床和治疗参数的预后意义。
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Clinical profiles and survival outcomes of adult patients with multiple myeloma at a tertiary hospital in the Philippines
Objectives The Filipino population is largely underrepresented in the currently available literature on multiple myeloma (MM). Herein, we aimed to determine the clinical profile, treatment, and outcomes of adult Filipinos with MM. Material and Methods The records of 74 patients with MM seen at our institution from 2016 to 2019 were retrospectively reviewed. Results The median age at diagnosis was 54 years, with the majority lumped in the 40–65 years age group. At diagnosis, anemia (hemoglobin <100 g/L) was present in 36 (64.3%) patients, but hypercalcemia (calcium ≥2.75 mmol/L) and azotemia (creatinine ≥177 umol/L) were seen in only 9 (20.0%) and 18 (34.0%) patients, respectively. Novel drugs (bortezomib, thalidomide, and lenalidomide) were used in 54 (84.4%) patients for frontline treatment. The overall response rate was 70.0% and the median overall survival (OS) was 60 months. On univariate analysis, only hemoglobin and the serum albumin levels affected survival. Conclusion Aside from the trend of a younger age at diagnosis, there are no unique clinical characteristics of MM seen in Filipinos. The longer OS may reflect the availability of newer drugs in the recent decade, but larger studies are needed to investigate the prognostic significance of several clinical and treatment parameters.
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