Clinical Analysis Of Multiple Myeloma With Hypercalcemia

Objective:To investigate the clinical characteristics of multiple myeloma with hypercalcemia.Methods: The subjects were MM patients who were hospitalized from June 2007 to June 2017 in the hematology department of the first affiliated hospital of hebei northern college.Collect the clinical data of patients,were retrospectively analyzed,including the patients' age,gender,clinical symptoms,types of myeloma,serum calcium levels,ISS stages,treatment,ORR and so on.All cases accord with the diagnostic criteria of 2001 WHO multiple myeloma.The curative effect was based on the international myeloma working group(IMWG)in 2006.Results:1.20 patients are diagnosed with hypercalcemia before the revise.36 patients are diagnosed after the revise with blood calcium level>2.75mmol·L-1.The morbidity of hypercalcemia was 16.90%(36/213).2.The patients of the hypercalcemia group with ISS stage III are significantly higher than the non-hypercalcemia group(73.33 % VS 52.03%).It is more likely to show the hypercalcemia group of symptoms of nervous system(58.33% VS 15.82%),urinary system(52.78% VS 20.90%),digestive system(69.44% VS 40.68%),skeletal system(63.89% VS 37.29%).Two groups have statistic differences in Hb,Scr,? 2-MG,LDH,CRP,and myeloma cells.There are no statistically significant differences in age,sex,myeloma type,WBC,PLT,ALP and so on.3.Hypercalcemia is treated with fluid infusion therapy,diuresis,glucocorticoid and bisphosphonate,the effective rate of 94.44%.4.Hypercalcemia group of ORR is 51.61%,(CR+VGPR)is 9.68%,PR is 41.94%.Non-hypercalcemia group of ORR is 75.80%,(CR+VGPR)is 29.94%,PR is 45.86%.The difference between the two groups is statistically significant.Conclusions: 1.MM is more easier to hypoproteinemia,needed to be revised of serum calcium.In order to avoid missed diagnosis.2.The clinical stage of patients with hypercalcemia are mostly ?.The clinical manifestations are complex and diverse.Involved a number of systems,especially when appear nervous,urinary system performance,should be alert for hypercalcemia.3.Hypercalcemia is an emergency of multiple myeloma and should be diagnosed and treated early.The combination therapy of fluid infusion,diuresis,glucocorticoid and bisphosphonate is an effective method.4.Multiple myeloma with hypercalcemia is low chemotherapy efficiency,poor prognosis and short survival.