以多浆膜腔积液为首发症状伴复杂染色体核型的多发性骨髓瘤一例并文献复习-东南大学学报医学版

以多浆膜腔积液为首发症状伴复杂染色体核型的多发性骨髓瘤一例并文献复习

单位：南京医科大学附属淮安第一医院血液科, 江苏淮安 223300

分类号：R551.3

出版年·卷·期（页码）：2018·37·第一期（129-133）

摘要：

多发性骨髓瘤（MM）是具有高度异质性的浆细胞恶性克隆性疾病，临床表现为单克隆免疫球蛋白聚集、低丙种球蛋白血症、高钙血症、肾损害、贫血及溶骨性病变，称为"CRAB"。MM早期诊断对治疗方案的选择与疗效的评估具有一定的影响，符合MM典型临床表现及特征性实验室检查结果，包括骨髓形态、免疫分型、免疫固定电泳及相关异常基因，诊断较易。然而，对于首发症状及临床表现不典型的患者早期诊断存在一定困难。本文报道以多浆膜腔积液为首发症状的MM患者1例，并复习相关文献，提高MM的早期诊断率。

Multiple myeloma(MM) is a kind of malignant colonial disease with heterogeneous clinical manifestations including plasma cell neoplasia, accumulation of monoclonal immunoglobulin, hypogammaglobulinemia and hypercalcemia, renal insufficiency, anemia, osteolytic lesions, commonly referred as CRAB features. The diagnosis of MM traditionally required end-organ damage(CRAB features) caused by the neoplastic clone of plasma cells. Here, we report an MM patient with polyserositis as initial symptom in order to improve the diagnosis of some atypical MM patients.

参考文献：

[1] PALUMBO A,ANDERSON K.Multiple myeloma[J].N Engl J Med,2011,364(11):1046-1060.
[2] RAJKUMAR S V,DIMOPOULOS M A,PALUMBO A,et al.International myeloma working Group updated criteria for the diagnosis of multiple myeloma[J].Lancet Oncol,2014,15(12):e538-e548.
[3] RAJKUMAR S V.Multiple myeloma:2014 update on diagnosis risk-stratification,and management[J].Am J Hematol,2014,89(10):999-1009.
[4] LANDGREN O,GRIDLEY G,TURESSON I,et al.Risk of monoclonal gammopathy of undetermined significance(MGUS) and subsequent multiple myeloma among African American and white veterans in the United States[J].Blood,2006,107(3):904-906.
[5] SHORT K D,RAJKUMAR S V,LARSON D,et al.Incidence of extramedullary disease in patients with multiple myeloma in the era of novel therapy,and the activity of pomalidomide on extramedullary myeloma[J].Leukemia,2011,25(6):906-908.
[6] 陈海飞,傅卫军,王东星,等.40例多发性骨髓瘤伴髓外病变患者的临床特征分析[J].中华血液学杂志,2007,28(10):655-658.
[7] BERGSAGEL P L,KUEHL W M.Chromosome translocations in multiple myeloma[J].Oncogene,2001,20(40):5611-5622.
[8] FONSECA R,BAILEY R J,AHMANN G J,et al.Genomic abnormalities in monoclonal gammopathy of undetermined significance[J].Blood,2002,100(4):1417-1424.
[9] SEIDL S,KAUFMANN H,DRACH J.New insights into the pathophysiology of multiple myeloma[J].Lancet Oncol,2003,4(9):557-564.
[10] RAJAN A M,RAJKUMAR S V.Interpretation of cytogenetic results in multiple myeloma for clinical practice[J].Blood Cancer J,2015,5(10):e365.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录