摘要
目的探讨低T3综合征(LT3S)与初诊多发性骨髓瘤(MM)患者预后的相关性。方法回顾性分析2009年7月至2020年12月江苏省人民医院血液科诊治的211例初诊MM患者,所有患者均进行了甲状腺功能检查以评估是否合并LT3S。分析LT3S与临床特征的相关性及对预后的影响。结果211例患者中男119例、女92例,中位年龄60(33~86)岁。与不伴LT3S患者相比,伴LT3S组患者初诊时β2-微球蛋白、C-反应蛋白和血肌酐水平明显升高(P值均<0.001),血红蛋白、血小板和血清白蛋白水平显著降低(P值分别为<0.001、0.018、<0.001),ISS分期Ⅲ期比例更高(P<0.001)。伴LT3S组较不伴LT3S组具有更短的中位无进展生存(PFS)期(16个月对30个月,P=0.003)和总生存(OS)期(57个月对75个月,P=0.004)。在多因素分析中,LT3S是影响患者PFS(HR=2.114,95%CI 1.271~3.516,P=0.004)和OS(HR=2.231,95%CI 1.088~4.577,P=0.029)的独立不良预后因素。结论LT3S和初诊MM患者预后不良显著相关。
Objective This study aimed to examine the relationship between low T3 syndrome(LT3S)and the prognosis of newly diagnosed multiple myeloma(NDMM)patients.Methods A retrospective examination of 211 NDMM patients treated at the Department of Hematology,Jiangsu Provincial People's Hospital from July 2009 to December 2020 was performed,and all patients received thyroid function testing to determine if they had LT3S.We investigated the relationship between LT3S and clinical features,as well as its impact on MM prognosis.Results Of the 211 patients,119 were males,and 92 were females,with a median age of 60(33-86)years.Patients with LT3S had significantly higher levels ofβ2-microglobulin,C-reactive protein,and blood creatinine compared to those with normal T3 levels.They also had lower levels of hemoglobin,platelets,and serum albumin,as well as more advanced ISS stages(P<0.001).Patients with LT3S had shorter progression-free survival(PFS)(16 months vs 30 months,P=0.003)and overall survival(OS)(57 months vs 75 months,P=0.004)than patients without LT3S.LT3S was found to be a standalone unfavorable factor in multivariate analysis,LT3S was an independent unfavorable factor in predicting both PFS(HR=2.114,95%CI 1.271-3.516,P=0.004)and OS(HR=2.231,95%CI 1.088-4.577,P=0.029).Conclusions Low T3 syndrome was an independent unfavorable prognostic predictor for NDMM.
作者
张珏
张丽娜
夏园
金媛媛
沈旭星
陈丽娟
Zhang Jue;Zhang Li'na;Xia Yuan;Jin Yuanyuan;Shen Xuxing;Chen Lijuan(Department of Hematology,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing 210029,China)
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2023年第3期216-221,共6页
Chinese Journal of Hematology
基金
国家自然科学基金(82070223)。
