Objective To investigate the clinical characteristics and prognosis of multiple myeloma(MM)patients with light chain(AL)amyloidosis.Methods A total of 260 MM patients were selected from Hangzhou first people's Hospital from January 2017 to January 2022,including 31 MM patients with AL(the MM with AL group)and 229 MM patients with MM alone(the MM group).Patients in both groups were treated with bortezomib based induction chemotherapy.Clinical characteristics,efficacy,and prognosis were compared between the two groups.Results There were no significant differences in gender,age,Durie-Salmon(DS)stage,and International Staging System(ISS)stage between the two groups(P>0.05).The λ-type AL involvement rate in the MM combined with AL group was higher than that in the MM group(P<0.05).There were no significant differences in the levels of white blood cell(WBC),platelet(PLT),alkaline phosphatase(ALP),Hemoglobin(Hb),albumin,serum creatinine,serum calcium,β2 microglobulin,24h urine protein,and type-B natriuretic peptide(BNP)between the two groups(P>0.05),and the MM combined with AL group lactate dehydrogenase(LDH)level was higher than that in the MM group(P<0.05).The objective response rate(ORR)of the MM combined with AL group was lower than that of the MM group(P<0.05).The proportion of patients with complete remission(CR)and the proportion of patients with very good partial remission(VGPR)in the MM combined with AL group were lower than those in the MM group(P>0.05).The median progression-free survival(PFS)and median overall survival(OS)of the MM combined with AL group were 23 months and 31 months,while those of the MM group were 45 months and 56 months.The OS of the MM combined with AL group was shorter than this of the MM group(P<0.05).The median OS of patients with cardiac amyloidosis in the MM combined with AL group was shorter than that of patients without cardiac amyloidosis(P<0.05).Conclusion Patients with MM combined with AL amyloidosis have poorer curative effect and shorter overall survival than patients with simple MM.
万方数据
维普
