[Clinical analysis of multiple myeloma-associated amyloidosis].

Objective: To investigate the clinical features and survival of multiple myeloma-associated amyloidosis patients. Methods: Twenty three multiple myeloma-associated amyloidosis patients were retrospectively analyzed from January 2009 to December 2016. Results: The overall response rate(ORR)was 65.2% and the remission rate (sCR+ CR) was 21.7%. The median progression-free survival(PFS) was fourteen months(1-63), and the median overall survival(OS)was fifteen months(3-63). The early death rate (death rate within one year)was 33.3%. The median OS of patients(n=9)with the performance status(PS) score >2 was seven months(1-15), and the median OS of patients(n=14)with the PS score ≤2 was thirty months(10-63). There was a statistically significant difference in OS(P<0.05); the median PFS and OS of the patients (n=15) who responded to inductive treatment were seventeen months(2-63) and twenty four months (4-63)respectively, and the median PFS and OS of the patients (n=8)who did not respond to inductive treatment were three months(1-8) and eleven months (3-15) respectively. There was a statistically significant difference in PFS and OS(P<0.05). There was a statistically significant difference in PFS and OS between patients treated with remission (n=5)and those who did not(n=18) (P<0.05). Conclusions: The multiple myeloma-associated amyloidosis patients had a high early death rate and short survival time. Early identification and effective treatment are the preconditions for improving the poor prognosis.目的： 探讨多发性骨髓瘤伴发淀粉样变性患者的临床特点以及生存情况。 方法： 回顾性分析2009年1月—2016年12月北京朝阳医院京西院区血液科收治的23例多发性骨髓瘤伴发淀粉样变性患者的临床资料。 结果： 治疗总有效率(ORR)为65.2%，缓解[严格完全缓解(sCR)＋完全缓解(CR)]率为21.7%；中位无进展生存(PFS)期为14(1～63)个月，中位总生存(OS)期为15(3～63)个月，早期死亡率(1年内死亡率)33.3%；体能状态(PS)评分>2分的患者(n＝9)中位OS为7(1～15)个月，PS评分≤2分的患者(n＝14)中位OS期30(10～63)个月，两组的总生存期比较，差异有统计学意义(P<0.05)。诱导治疗有效的患者(n＝15)与无效的患者(n＝8)，中位PFS期分别为17(2～63)个月和3(1～8)个月，中位OS分别为24(4～63)个月和11(3～15)个月，分别比较PFS期和OS期，差异均有统计学意义(均P<0.05)。诱导治疗缓解的患者(n＝5)与未缓解的患者(n＝18)，PFS期和OS期差异均有统计学意义(均P<0.05)。 结论： 多发性骨髓瘤伴发淀粉样变性的患者早期死亡率高，生存期短；早期识别和有效治疗是改善其不良预后的前提。.