Retrospective Analysis Of256Cases Of Multiple Myeloma

Objectives：Diagnosis and treatment status of patients with multiple myelomawere retrospectively analyzed in recent five years in our hospital.Weanalyzed the efficacy and adverse reactions of different options, people,therapeutic method. We analyzed the treatment status, problems. Toguide the clinician to treat for patients with multiple myeloma.Method：We chose256cases of MM patients hospitalized in our hospitalsince June2006to October2011.207cases were newly diagnosedpatients,49cases were relapsed or refractory patients.We analyzed thepatient’s age, gender distribution, classification, staging status, misdiagnosis,chromosomes, FISH detection and treatment status.Results：1. The median age was62years(26to89years) in207cases of newlydiagnosed patients, the peak age was50to69years.2.41cases were misdiagnosed in207cases of newly diagnosed patients,and the misdiagnosis rate was19.8%.3. Clinical type: IgG was the most common type，it accounted for45.7%(117cases). Clinical stage DS stage: the most common was Ⅲ stage，it accounted for83.2%(213cases). The patients with ISS stage Ⅰ, ⅡandⅢ were23,25and80cases，respectively.4. We got Chromosome result of78cases in207cases of newlydiagnosed patients，21cases (26.9%) had chromosomal abnormalities.43 patients underwent a FISH detection，31cases (72.1%) detected abnormalkaryotype.13q deletion,1q21amplification and IgH translocation were themost common abnormal karyotype.5. The mainly treatment regimen was bortezomib-based regimen andmelphalan-based regimen. The two groups in the overall response ratewas82.9%,68.2%, the difference was statistically significant（P＝0.035）.6. There was no significant difference in the overall response ratebetween the elderly group and the young group (P＞0.05) after1or3courses of therapy. Infection and peripheral neuropathy was common, itwas relatively high incidence of adverse reactions in elderly group，therewas no difference statistically significant(P＞0.05).7.The elderly patients treated with VDT could achieve better efficacy.The efficacy between MPT and VDT was statistically significant（P＝0.012）.The difference in survival of the two groups were not statisticallysignificant(P＞0.05).8. There was no significant difference in the overall response ratebetween the2groups after1or3courses of therapy(P＞0.05).The overallresponse rate3courses was higher than1courses, the difference wasstatistically significant（P＝0.030）.Relatively high incidence of peripheralneuropathy adverse reactions in twice-weekly group than once-weekly group，there was no difference statistically significant(P＞0.05).Conclusions：1. The misdiagnosis rate of MM was high, arrived late stage.2. The genetic abnormalities detected rate of FISH was significantlysuperior to conventional chromosome testing.3. The efficacy of bortezomib-based regimen was superior to melphalan-based regimen. 4. The age factor did not affect the efficacy of bortezomib，but adversereactions in elderly group tended to increase.5. The untreated elderly patients treated with VDT could achieve betterefficacy than MPT，but adverse reactions in VDT group tended to increase.6. The efficacy did not appear to be affected by the bortezomib dosingschedule，extended bortezomib drug interval had a lower adverse reaction trend.