Nima Ghalehsari, Sofia Zahid, Olivia Main, Soeb Usta, John Patresan, Adina Amin, Farah Ashraf, Anita Mazloom, Andy Huang, Mendel Goldfinger, Jorge Monge
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引用次数: 0
摘要
背景:多发性骨髓瘤(MM)是一种浆细胞肿瘤:多发性骨髓瘤(MM)是一种浆细胞肿瘤,每年占美国癌症的 1-2%,约占血液恶性肿瘤的 17%。有症状的 MM 患者中,50% 的患者在转诊至专科医生之前需要接受三次或三次以上的初级保健就诊,这一比例高于其他任何癌症。多发性骨髓瘤的诊断延迟已被证明会对疾病的临床过程产生负面影响;诊断间隔时间较长的患者无病生存期较短,治疗相关并发症的发生率较高:我们对在本院确诊的 MM 患者进行了回顾性分析,以确定从首次检测到实验室异常到确诊 MM 的时间:本研究共纳入 92 例患者。52%的患者在确诊时患有孤立性贫血。29%的患者诊断延迟≥1年,18%的患者诊断延迟≥3年。我们的队列中有 9 名患者患有贫血和血清总蛋白升高(31%)。这组患者的TTD时间最长,中位数为38个月:我们的研究结果显示,不同种族、民族、性别或社会经济地位的患者在确诊时间上没有任何差异。
Exploring health disparities in diagnosing multiple myeloma.
Background: Multiple myeloma (MM) is a plasma cell neoplasm, which accounts for 1-2% of cancers and approximately 17% of hematological malignancies in the United States each year. Fifty percent of patients with symptomatic MM have three or more primary care visits before being referred to a specialist, which is greater than any other cancer. A delay in the diagnosis of multiple myeloma has been shown to negatively impact the clinical course of the disease; patients with longer diagnostic intervals have been shown to experience shorter disease-free survival and higher rates of treatment-related complications.
Research design and methods: We performed a retrospective analysis of patients diagnosed with MM in our institution, to determine the time from the first detectable lab abnormality to the diagnosis of MM.
Results: We included 92 patients in this study. Fifty-two percent of patients had isolated anemia at the time of diagnosis. Twenty-nine percent of patients had a delay in diagnosis of ≥1 year, while 18% had a delay of ≥3 years. Nine patients in our cohort had anemia and an elevated serum total protein (31%). This group had the longest time to diagnosis with a median of 38 months.
Conclusions: Our results did not show any difference in time to diagnosis by race, ethnicity, gender, or socioeconomic status.
期刊介绍:
Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.