Background： Elderly multiple myeloma （MM） patients often tend to suffer a variety of diseases, so the treatment of choice is very difficult for the elderly myeloma patients. The overall survival （OS） time and sid...Background： Elderly multiple myeloma （MM） patients often tend to suffer a variety of diseases, so the treatment of choice is very difficult for the elderly myeloma patients. The overall survival （OS） time and side effects with elderly patients are unclear in China. The study tried to find out the role of geriatric assessment in the Chinese elderly MM. Methods： We retrospectively analyzed the data of 628 newly diagnosed patients from six hospitals from June 2011 to June 2013. A geriatric assessment had been performed to assess comorbidities, cognitive, and physical status for these patients. The primary endpoint was to evaluate different physical states of elderly patients with OS time and treatment-related side effects. Results： An additive scoring system （range： 0-5）, based on age, Katz＇s Activity of Daily Living （ADL） and Lawton＇s Instrumental Activity of Daily Living （IADL） 〈5 and Charlson Comorbidity Index （CC1） was developed to identify three groups： fit （score = 0）; intermediate-fitness （score = 1 ）; and fi＇ail （score ≥2）. The 3-year OS was 63% in fit patients, 63% in intermediate-fimess patients, and 49% in frail patients ≥3 hematologic adverse events （AEs） were documented in 45 （35.4%） fit, 34 （34%） intermediate-fitness, and 121 （30.2%） frail patients. The risk of a grade ≥3 hematologic AEs was not significantly increase in intermediate-fitness （hazard ratios [HR]： 0.99, 95% confidence interval [CI]： 0.54 1.47, P = 1.000） and in frail patients （tfR： 1.16, 95% CI： 0.70-1.93, P- 0.558） compared with fit ones. Conclusions： MM occurs earlier in life and being advanced when the diagnosis is made in the mainland of China. The overall survival in fi＇ailty with International Staging System （ISS） ll/lll was the worst in all patients.展开更多
To the Editor:In the past 10 years,remarkable progress has been made in the treatment of multiple myeloma(MM).In clinical practice,we used Durie-Salmon Staging System(DSS),International Staging System(ISS),and revised...To the Editor:In the past 10 years,remarkable progress has been made in the treatment of multiple myeloma(MM).In clinical practice,we used Durie-Salmon Staging System(DSS),International Staging System(ISS),and revised ISS to judge the prognosis of myeloma patients.MM is divided into eight types,the type of IgA is considered to be poor prognosis,but so far there is no evidence basis of literature.We analyzed the clinical features and living conditions of IgA type MM patients in the real world.展开更多
To the Editor:Hyponatremia,defined as a serum sodium concentration<135 mmol/L,is the most common waterelectrolyte imbalance in clinical practice.Hyponatremia can be a complication of other diseases(eg,heart failure...To the Editor:Hyponatremia,defined as a serum sodium concentration<135 mmol/L,is the most common waterelectrolyte imbalance in clinical practice.Hyponatremia can be a complication of other diseases(eg,heart failure,renal failure,pneumonia).Hyponatremia can be divided into three main classes:hypovolemic;euvolemic,hypervolemic.The pathogenesis of hyponatremia including taking drugs such as water pills(diuretics)and some antidepressants and pain medications;heart failure and kidney or liver disease,bouts of chronic,severe diarrhea or vomiting.展开更多
文摘Background： Elderly multiple myeloma （MM） patients often tend to suffer a variety of diseases, so the treatment of choice is very difficult for the elderly myeloma patients. The overall survival （OS） time and side effects with elderly patients are unclear in China. The study tried to find out the role of geriatric assessment in the Chinese elderly MM. Methods： We retrospectively analyzed the data of 628 newly diagnosed patients from six hospitals from June 2011 to June 2013. A geriatric assessment had been performed to assess comorbidities, cognitive, and physical status for these patients. The primary endpoint was to evaluate different physical states of elderly patients with OS time and treatment-related side effects. Results： An additive scoring system （range： 0-5）, based on age, Katz＇s Activity of Daily Living （ADL） and Lawton＇s Instrumental Activity of Daily Living （IADL） 〈5 and Charlson Comorbidity Index （CC1） was developed to identify three groups： fit （score = 0）; intermediate-fitness （score = 1 ）; and fi＇ail （score ≥2）. The 3-year OS was 63% in fit patients, 63% in intermediate-fimess patients, and 49% in frail patients ≥3 hematologic adverse events （AEs） were documented in 45 （35.4%） fit, 34 （34%） intermediate-fitness, and 121 （30.2%） frail patients. The risk of a grade ≥3 hematologic AEs was not significantly increase in intermediate-fitness （hazard ratios [HR]： 0.99, 95% confidence interval [CI]： 0.54 1.47, P = 1.000） and in frail patients （tfR： 1.16, 95% CI： 0.70-1.93, P- 0.558） compared with fit ones. Conclusions： MM occurs earlier in life and being advanced when the diagnosis is made in the mainland of China. The overall survival in fi＇ailty with International Staging System （ISS） ll/lll was the worst in all patients.
基金supported by a grant from Beijing Natural Science Foundation(No.7162067).
文摘To the Editor:In the past 10 years,remarkable progress has been made in the treatment of multiple myeloma(MM).In clinical practice,we used Durie-Salmon Staging System(DSS),International Staging System(ISS),and revised ISS to judge the prognosis of myeloma patients.MM is divided into eight types,the type of IgA is considered to be poor prognosis,but so far there is no evidence basis of literature.We analyzed the clinical features and living conditions of IgA type MM patients in the real world.
基金This study was supported by a grant from the Beijing Natural Science Foundation(No.7162067).
文摘To the Editor:Hyponatremia,defined as a serum sodium concentration<135 mmol/L,is the most common waterelectrolyte imbalance in clinical practice.Hyponatremia can be a complication of other diseases(eg,heart failure,renal failure,pneumonia).Hyponatremia can be divided into three main classes:hypovolemic;euvolemic,hypervolemic.The pathogenesis of hyponatremia including taking drugs such as water pills(diuretics)and some antidepressants and pain medications;heart failure and kidney or liver disease,bouts of chronic,severe diarrhea or vomiting.
