Korean J Hematol 2001; 36(1):
Published online March 31, 2001
© The Korean Society of Hematology
다발성 골수종의 항암화학요법 성적 및 예후인자
송용환, 류백렬, 김봉석, 박연희, 임영혁, 김태유, 정성문, 이진옥, 김연경, 김종광, 유성재, 강윤구
원자력병원 내과,
한국보훈병원 내과,
서울위생병원 내과,
성균관대학교 의과대학 삼성서울병원 내과,
서울대학교 의과대학 내과학교실,
울산대학교 의과대학 서울중앙병원 종양혈액내과
Retrospective Analysis of Treatment Outcome and Prognostic Factors in Multiple Myeloma
Background: The prognostic outlook for multiple myeloma has markedly improved in recent decades, which is probably related to the introduction of chemotherapy and the development of supportive care for various complications. In the present
work
we analysed retrospectively the therapeutic outcomes of newly diagnosed patients with multiple myeloma treated at Korea Cancer Center Hospital (KCCH). And we studied to identify prognostic factors influencing the therapeutic outcome of the
disease.
Methods: Between January 1987 and December 1998, eightly three patients were diagnosed as multiple myeloma by the criteria of Southwestern Oncology Group at KCCH. Of these patients, clinical analysis was performed retrospectively for
sixty-one
patients who were treated with combination chemotherapy.
Results: The median age at diagnosis was 55 years of age, which was lower than that of western countries and 48% of patients were in their 4th decade. Male to female ratio was 1:1.1. The main chief complaint at diagnosis was bone pain.
Ninety-one
percent of the patients were clinical stage Ⅲ. Serum immuno-electro-phoresis revealed M-protein as IgG in 41%. The ratio of κ to λ light chain was 1.5:1. The response rate to initial chemotherapy was 75% (95% C. I.=63.4~86.6%) and median
progression
free interval was 20.9 months. The median overall survival of total 61 patients was 28.5 months. The patients' age at diagnosis and the response to initial chemotherapy were statistically significant prognostic factors influencing the overall
survival
of patients.
Conclusion: The study showed that we could get relatively high response rate with conventional chemotherapy for the patients with multiple myeloma, but, that most patients eventually progressed and the cure was nearly impossible. To obtain
cure
or to have much longer survival time, we need more delicate strategies including more intensive chemotherapy with stem cell transplantation for the treatment of multiple myeloma patients.
Keywords Multiple myeloma; Treatment outcome; Prognostic factors;
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Korean J Hematol 2001; 36(1): 9-17
Published online March 31, 2001
Copyright © The Korean Society of Hematology.
다발성 골수종의 항암화학요법 성적 및 예후인자
송용환, 류백렬, 김봉석, 박연희, 임영혁, 김태유, 정성문, 이진옥, 김연경, 김종광, 유성재, 강윤구
원자력병원 내과,
한국보훈병원 내과,
서울위생병원 내과,
성균관대학교 의과대학 삼성서울병원 내과,
서울대학교 의과대학 내과학교실,
울산대학교 의과대학 서울중앙병원 종양혈액내과
Retrospective Analysis of Treatment Outcome and Prognostic Factors in Multiple Myeloma
Yong Whan Song, Baek Yeol Ryoo, Bong Seog Kim, Yeon Hee Park, Young Hyuck Im, Tae You Kim, Sung Moon Jung, Jin Ok Lee, Yeon Kyeong Kim, Jong Gwang Kim, Sung Jae Yoo, Yoon Koo Kang
Department of Internal Medicine, Korea Cancer Center Hopital, Seoul, Korea
Abstract
Background: The prognostic outlook for multiple myeloma has markedly improved in recent decades, which is probably related to the introduction of chemotherapy and the development of supportive care for various complications. In the present
work
we analysed retrospectively the therapeutic outcomes of newly diagnosed patients with multiple myeloma treated at Korea Cancer Center Hospital (KCCH). And we studied to identify prognostic factors influencing the therapeutic outcome of the
disease.
Methods: Between January 1987 and December 1998, eightly three patients were diagnosed as multiple myeloma by the criteria of Southwestern Oncology Group at KCCH. Of these patients, clinical analysis was performed retrospectively for
sixty-one
patients who were treated with combination chemotherapy.
Results: The median age at diagnosis was 55 years of age, which was lower than that of western countries and 48% of patients were in their 4th decade. Male to female ratio was 1:1.1. The main chief complaint at diagnosis was bone pain.
Ninety-one
percent of the patients were clinical stage Ⅲ. Serum immuno-electro-phoresis revealed M-protein as IgG in 41%. The ratio of κ to λ light chain was 1.5:1. The response rate to initial chemotherapy was 75% (95% C. I.=63.4~86.6%) and median
progression
free interval was 20.9 months. The median overall survival of total 61 patients was 28.5 months. The patients' age at diagnosis and the response to initial chemotherapy were statistically significant prognostic factors influencing the overall
survival
of patients.
Conclusion: The study showed that we could get relatively high response rate with conventional chemotherapy for the patients with multiple myeloma, but, that most patients eventually progressed and the cure was nearly impossible. To obtain
cure
or to have much longer survival time, we need more delicate strategies including more intensive chemotherapy with stem cell transplantation for the treatment of multiple myeloma patients.
Keywords: Multiple myeloma, Treatment outcome, Prognostic factors,
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