多发性骨髓瘤继发骨髓纤维化的骨髓病理学特征及与疾病预后的关系

发布时间：2018-11-12 18:25

【摘要】：目的:探讨多发性骨髓瘤继发骨髓纤维化的骨髓活检病理特征及其与疾病预后的关系。方法:回顾性分析2012年1月1日至12月31日期间本院血液内科收治的70例(其中35例患者继发骨髓纤维化)多发性骨髓瘤患者临床资料。观察患者骨髓活检病理学特征,对比分析骨髓涂片及活检增生程度、治疗后纤维化程度的变化,同时比较继发骨髓纤维化与未发生骨髓纤维化患者之间总死亡率的差异。结果:各期、各分型多发性骨髓瘤均可继发骨髓纤维化,骨髓纤维化可致骨髓涂片出现假性增生减低,继发骨髓纤维化患者骨髓纤维组织不同程度增生,Gomori染色阳性(+)至强阳性(+++),部分患者疾病好转后骨髓纤维化程度可减轻。结论:多发性骨髓瘤继发骨髓纤维化时骨髓活检对诊断有重要价值,继发骨髓纤维化患者较未发生纤维化患者总体预后欠佳。
[Abstract]:Objective: to investigate the pathological features of bone marrow biopsy and its relationship with the prognosis of multiple myeloma secondary to bone marrow fibrosis. Methods: the clinical data of 70 patients with multiple myeloma from January 1 to December 31, 2012 were retrospectively analyzed. The pathological features of bone marrow biopsy were observed and the degree of bone marrow smear and biopsy hyperplasia were compared and the changes of fibrosis degree after treatment were analyzed. The difference of total mortality between the patients with secondary bone marrow fibrosis and those without bone marrow fibrosis was also compared. Results: all types of multiple myeloma could be secondary to myelofibrosis, and myelofibrosis could lead to pseudoproliferative decrease in bone marrow smears and proliferation of bone marrow fiber tissue in patients with secondary myelofibrosis. The degree of bone marrow fibrosis can be alleviated after the improvement of disease in some patients with Gomori positive () to strong positive (),. Conclusion: bone marrow biopsy in patients with multiple myeloma secondary to bone marrow fibrosis is of great value in the diagnosis, and the prognosis of the patients with secondary myeloma fibrosis is worse than that of the patients without fibrosis.
【作者单位】：西安交通大学第一附属医院血液内科;
【分类号】：R733.3

【相似文献】