POVEZANOST KOŠTANE BOLESTI I DRUGIH KLINIČKIH PARAMETARA U BOLESNIKA S MULTIPLIM MIJELOMOM

UVOD: Multipli mijelom neizlječiva je zloćudna bolest plazma stanica, očitovana infiltracijom koštane srži, promjenom mikrookoliša te razvoja odgovarajuće kliničke slike. MATERIJALI I METODE: Učinjena je deskriptivna analiza podataka vezanih za tip mijeloma i lakih lanaca, anemiju, CRP, kreatinin, kalcij, LDH, kliničkog sustava stupnjevanja po DS i ISS, prisutnost koštane boli i koštane patologije te naposljetku usporedba koštane patologije i hiperkalcemije s odgovorom na terapiju i preživljenjem. Od 98 pacijenata uključenih u istraživanje, 51 pacijent (52%) je bio muškog spola, a 47 (48%) pacijenata ženskog spola. Medijan praćenja bolesnika iznosio je 17 mjeseci, minimalno 1 mjesec a maksimalno 71 mjesec. Podaci su obrađeni u programima STATISTICA Stat Softver 12., te Microsoft Excel 2007. Za kategorijske varijable korišten je Fisher egzaktni test i Hi kvadrat. REZULTATI: Dominantni razred imunoglobulina je IgG a lakih lanaca kappa. Od laboratorijskog nalaza dominantni nalaz je bila anemija (54 ispitanika, 60%). Prema DS prognostičkom sustavu stupnjevanja najveći broj bolesnika bio je 2A stadija (30 bolesnika), a prema ISS sustavu stadija 3 (37 bolesnika). Bol je bila prisutna kod 44 bolesnika (53%), dok je od koštane patologije najveću učestalost imale patološke frakture kod 51 bolesnika. Nije utvrđena statistički značajna razlika u odgovoru na terapiju i preživljenje u grupama bolesnika s koštanom bolesti te hiperkalcemijom. RASPRAVA: Dobiveni deskriptivni rezultati uglavnom odgovaraju literaturnim podacima drugih studija, dok u slučaju koštane bolesti i hiperkalcemije nije utvrđena statistički značajna povezanost s odgovorom na terapiju i preživljenje.INTRODUCTION: Multiple myeloma is an incurable malignancy of plasma cells, manifested by bone marrow infiltration, change in the microenvironment and the development of appropriate clinical presentation. MATERIALS AND METHODS: Descriptive analysis of data related to the type of myeloma and light chains, anemia, CRP, creatinine, calcium, LDH, staging system by DS and ISS, the presence of bone pain, bone pathology and finally comparison of bone pathology and hypercalcemia with response to therapy and survival. Of the 98 patients included in the study, 51 patients (52%) were male and 47 (48%) of patients were female. Median follow-up was 17 months, a minimum of 1 month and a maximum of 71 months.. The data were processed in the Statistica software Stat12, and Microsoft Excel2007. For analysis of categorical variables was used Fisher's exact test and Chi-square. RESULTS: The predominant immunoglobulin class was IgG, and kappa for the light chain class. From laboratory results dominant finding was anemia (54 patients, 59%). According to DS staging system, the highest number of patients were 2A staged (30 patients), and according to ISS system, the dominant stage was stage 3 (37 patients). Pain was present in 44 patients (53%), while the bone pathology had the highest incidence of pathological fractures in 51 patients. No significant difference was found in the response to treatment and survival in groups of patients with bone disease and hypercalcemia. DISCUSSION: The obtained results correspond to literature findings of other studies, while in the case of bone disease and hypercalcemia, significant association has not been found with response to treatment and survival