概要
多发性骨髓瘤(MM)细胞的生长和存活依赖于骨髓微环境,其中细胞因子常与疾病的不良预后有关。在新药治疗时代,血清细胞因子水平对MM预后作用需进一步评估。本研究分析了157例初诊MM患者外周血细胞因子水平(包括白细胞介素-2(IL-2)、IL-4、IL-6、IL-10、干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)和IL-17A)与患者基线临床特征、疗效以及预后之间的关系。并选用15例年龄契合的健康志愿者和96例复发MM患者作为对照。所有患者均一线接受硼替佐米为基础方案的治疗。生存分析表明,上述细胞因子中,仅血清IL-10与患者的无进展生存期(PFS)和总生存期(OS)显著相关。初诊MM患者中,有103例(65.6%)患者被归为高IL-10(≥1.42 pg/mL)组,该组患者通常具有高危基因异常和临床分期,也更容易出现贫血、血小板减少,以及血清乳酸脱氢酶、C-反应蛋白和肌酐水平增高的症状。单因素分析表明高IL-10组患者有更差的PFS(P=0.040)和OS(P<0.001),多因素分析提示血清IL-10是初诊MM患者OS的独立预后因素。研究结果提示,血清IL-10水平与MM患者疾病进展和高危临床特征相关,可作为以硼替佐米为基础治疗方案的初诊MM患者OS的预后因素。
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Acknowledgments
This work was supported by the National Natural Science Foundation of China (Nos. 81800201 and 81872322), the Zhejiang Key Research and Development Project (No. 2020C03014), and the Key Project of Zhejiang Provincial Natural Science Foundation of China (No. LZ22H160009).
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Xiaoyan YUE wrote and translated part of the manuscript, reviewed literature, managed the patients, and collected clinical data. Linlin HUANG, Yang YANG, Yi ZHAO, Donghua HE, Xiaoyan HAN, Gaofeng ZHENG, Yi LI, Enfang ZHANG, Zhen CAI, and Xin HUANG reviewed and wrote a part of the manuscript and provided suggestions. Jingsong HE wrote a part of the manuscript, reviewed the literature, managed the patients, collected clinical data, and provided suggestions. All authors have read and approved the final manuscript, and therefore, have full access to all the data in the study and take responsibility for the integrity and security of the data.
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Xiaoyan YUE, Linlin HUANG, Yang YANG, Yi ZHAO, Donghua HE, Xiaoyan HAN, Gaofeng ZHENG, Yi LI, Enfan ZHANG, Zhen CAI, Xin HUANG, and Jingsong HE declare that they have no conflict of interest.
The studies involving human participants were reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang University (No. IIT20210091A). All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.
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Yue, X., Huang, L., Yang, Y. et al. High levels of serum IL-10 indicate disease progression, extramedullary involvement, and poor prognosis in multiple myeloma. J. Zhejiang Univ. Sci. B 23, 968–974 (2022). https://doi.org/10.1631/jzus.B2200277
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DOI: https://doi.org/10.1631/jzus.B2200277