多发性骨髓瘤(MM),成熟的B细胞谱系肿瘤,其特征在于浆细胞的异常克隆增殖和单克隆蛋白(M蛋白)的存在。这项研究是为了揭示呈现的特征,实验室发现,东部肿瘤协作组(ECOG)对多发性骨髓瘤患者的表现状况和骨骼调查。这个描述性的,横断面研究是在血液科进行的,达卡医学院附属医院,达卡,孟加拉国从2019年1月至2020年7月,样本量为81。在获得患者和/或其法定监护人的知情口头同意后,以病例记录表收集数据。考虑了相关的道德问题和数据质量保证。数据用SPSS进行分析,版本25.0,在数字和表格中显示频率,百分比,基于数据性质的平均值和标准偏差。以5.0%的显著性水平适当地进行统计测试以评估统计关联。患者的平均年龄为58.9±12.0岁。男性女性比例为2:1。35例(43.2%)患者是吸烟者,只有2例(2.5%)有血液恶性肿瘤家族史。骨痛(72.8%)是最常见的表现特征,而高血压(59.1%),糖尿病(29.5%),呼吸系统疾病(11.3%)和心脏病(11.4%)是常见的合并症.最常见的ECOG表现状态是ECOG-1(48.1%)。第1小时平均血红蛋白(Hb)为9.4±2.3gm/dl,平均红细胞沉降率(ESR)为89.5±42.1mm。42例中,平均血清肌酐水平为2.0±1.85mg/dl,≥2.0mg/dl(34.2%)。在50份文献中,血清乳酸脱氢酶(LDH)升高了18份(36.0%)。10例(14.5%)患者的平均血清钙水平为9.6±1.8mg/dl>11.0mg/dL。37例血清白蛋白<3.5gm/dl(49.3%),β2-微球蛋白>5.5mg/dl37例(57.8%),国际分期系统(ISS)III期占59.4%,BenceJones蛋白(BJP)占46.7%。溶解性病变占75.0%,38例(74.5%)患者受累,而18根(35.2%)肋骨受累,14例(27.5%)患者涉及颅骨,3例(5.9%)患者涉及股骨骨,肱骨,胸骨和肩胛骨.平均浆细胞百分比为62.1±24.9%。免疫固定电泳(IFE)显示IgG(72.7%),IgA(18.2%),游离轻链(FLC)(9.1%)。29.0%病例中FLC比率≥100。观察到血清肌酐与Hb浓度之间的显着统计关联(p<0.05)。血清肌酐水平与ISS分期(p<0.05)和血清钙水平(p<0/05),而BJP存在状态与血清肌酐水平之间无明显相关性(p>0.05)。骨痛,疲劳,发热和神经功能缺损是常见的表现特征.贫血,肾脏损害和骨骼溶解事件是突出的体格检查结果.ISS分期与血清肌酐水平有统计学关联,而血清钙水平与血清肌酐和溶解性病变相关。
Multiple myeloma (MM), mature B-cell lineage neoplasm, is characterized by abnormal clonal proliferation of plasma cells and presence of monoclonal protein (M protein). The study was conducted to reveal presenting features, laboratory findings, Eastern Cooperative Oncology Group (ECOG) performance status and skeletal survey on patients with multiple myeloma. This descriptive, cross-sectional study was carried out in the Department of Haematology, Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2019 to July 2020 with a sample size of 81. Data were collected in a case record form after obtaining informed verbal consent from patients and /or their legal guardians. Relevant ethical issues and data quality assurance were taken into consideration. Data were analyzed with SPSS, Version 25.0 with presentation in figures and tables with frequency, percentage, mean and standard deviation based on data nature. Statistical tests were carried out as appropriate with 5.0% level of significance for assessing statistical association. Mean age of the patients was 58.9±12.0 years. Male female ratio was 2:1. 35(43.2%) patients were smokers with only 2(2.5%) had family history of haematological malignancies. Bone pain (72.8%) was the most common presenting feature, while hypertension (59.1%), diabetes mellitus (29.5%), respiratory illness (11.3%) and cardiac disease (11.4%) were the common co-morbidities. Most common ECOG performance status was ECOG-1(48.1%). Mean haemoglobin (Hb) was 9.4±2.3gm/dl and mean erythrocyte sedimentation rate (ESR) was 89.5±42.1 mm in 1st hour. Mean serum creatinine level was 2.0±1.85 mg/dl and ≥2.0mg/dl in 42(34.2%). Among 50 documentation serum lactate dehydrogenase (LDH) was raised in 18(36.0%). Mean serum calcium level was 9.6±1.8mg/dl >11.0mg/dL in 10(14.5%) cases. Serum albumin <3.5gm/dl in 37(49.3%), β2-microglobulin >5.5mg/dl in 37(57.8%) cases, International staging system (ISS) stage III was in 59.4% and Bence Jones Protein (BJP) was present in 46.7% cases. Lytic lesions were present in 75.0%, In 38(74.5%) patients vertebrae were involved, while in 18(35.2%) ribs were involved, in 14(27.5%) patients skull was involved and in 3(5.9%) patients involved bones were femur, humerus, sternum and scapula. Mean plasma cells percentage was 62.1±24.9%. Immuno-Fixation Electrophoresis (IFE) revealed IgG (72.7%), IgA (18.2%), Free light chain (FLC) (9.1%). FLC ratio was ≥100 in 29.0% cases. Significant statistical association was observed between serum creatinine with Hb concentration (p<0.05), serum creatinine level with ISS staging (p<0.05) and serum calcium level (p<0/05), while insignificant association was revealed between BJP present status and serum creatinine level (p>0.05). Bone pain, fatigue, fever and neurological impairment were the common presenting features. Anaemia, renal impairment and skeletal lytic events were the prominent physical findings. ISS staging was statistically associated with serum creatinine level, while serum calcium level was associated with serum creatinine and lytic lesions.