肿瘤细胞治疗研究
英文原题：Effect of metachronous primary and secondary solid cancers in patients with multiple myeloma: a retrospective study from a single-center.
男性患者、65 岁患者，以及伴有 ISS III 期和 MPMST 的 MM 患者预后更差。
转化相关性声明：同时发生的原发恶性实体瘤（MPMST）对多发性骨髓瘤（MM）患者生存风险和预后的影响，以及 MPMST 在 MM 之前或之后发生是否存在差异，仍不清楚。利用经过详细表征的个体患者临床资料，我们发现，年龄较大的 MM 患者（≥65 岁）发生 MPMST 的风险更高。合并 MPMST 的 MM 患者中，男性、年龄 ≥65 岁以及国际分期系统（ISS）III 期患者预后更差。MM 发生前后最常见的三种实体癌均为肺癌、甲状腺癌和乳腺癌。这些发现为合并 MPMST 的 MM 患者精准治疗提供详细信息。目的：分析 MPMST 对 MM 的影响，以及 MPMST 在 MM 前后发生时的风险差异。方法：收集 2015 至 2023 年合并 MM 和 MPMST 患者的回顾性资料，包括性别、年龄、免疫球蛋白同种型、ISS 分期和治疗。分别使用检验、Logistic 回归分析和 Cox 模型比较变量、风险和生存差异。结果：在 2,167 例 MM 患者中识别出 34 例（1.57%）合并 MPMST 患者，其总生存较短。合并 MPMST 的 MM 患者中，男性（HR 3.96，95% CI 1.05–14.96）、年龄 ≥65 岁（HR 3.30，95% CI 1.41–7.71）和 ISS III 期患者（HR 4.08，95% CI 0.81–20.65）生存风险更高。CAR-T 治疗后发生 MM 的患者，第二实体癌发生率未增加，总生存时间也未延长。此外，MM 前后发生的最常见三类实体癌是肺癌、甲状腺癌和乳腺癌。结论：合并 MPMST 的男性、年龄 ≥65 岁和 ISS III 期 MM 患者预后较差。
STATEMENT OF TRANSLATIONAL RELEVANCE: Effects of metachronous primary malignant solid tumor (MPMST) on survival risk and prognosis of multiple myeloma (MM) and differences between MPMST occurring before and after MM remains unclear. Use of well-characterized clinical information of individual patient, we found that older patients with MM ( 65 years) had a higher risk of developing MPMST. Patients with MM and MPMST including male patients, aged 65 years and those with ISS stage III had a worse prognosis. The top three solid cancers occurred before and after MM were the lung, thyroid, and breast cancer. These findings provide detailed information for the precise treatment of patients with MM and MPMST. OBJECTIVE: To analyze the effects of MPMST on MM and the risk difference of MPMSTs occurring before and after MM. METHODS: Retrospective data from patients with MM and MPMST, including sex, age, immunoglobulin isotype, ISS stage, and therapy, were collected from 2015 to 2023. Differences in variables, risk, and survival were compared using the test, logistic regression analysis and the Cox model, respectively. RESULTS: The 34 (1.57%) patients with MM and MPMST identified from a total of 2167 MM patients had a shorter overall survival. The survival risk was higher in male patients with MM and MPMST (HR: 3.96, 95% CI: 1.05 -14.96), in those aged 65 years (HR: 3.30, 95% CI: 1.41 -7.71), and with ISS stage III (HR: 4.08, 95% CI: 0.81-20.65). Patients with MM subsequent to CAR-T cell therapy had neither enhanced incidence rates of second solid cancers nor had longer overall survival time. Furthermore, the top three solid cancers occurred before or after MM were lung, thyroid, and breast cancer. CONCLUSION: Male patients, aged 65 years and MM patients with ISS stage III and MPMST had a worse prognosis.
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