Avtor/Urednik		Mlakar, U
Naslov		Pomen določanja sečnine in timidin kinaze v serumu za oceno prognoze diseminiranega plazmocitoma
Prevedeni naslov		Prognostic value of serum thymidine kinase and urea in multiple myeloma
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 64, št. 10
Leto izdaje		1995
Obseg		str. 559-63
Jezik		slo
Abstrakt		Background. Survival in multiple myeloma varies from a few months to many years. The pre-treatment evaluation of prognosis in multiple myeloma is still inadequate for detection of the optimal therapeutic procedures in individual patient. The Durie and Salmon staging system and serum of beta2-microglubulin are used wordwilde because of their easy clinical application. Both parameters mainly reflect tumor burden. It has been shown that proliferative activity of myeloma cells (i.e., labelling index) is powerful independent prognostic factor. However this test is too complex and time consuming to be widely used. Serum thymidine kinase levels has been shown to reflect tumour cell proliferative activity. The aim of the present study was to evaluate the prognostic valve of serum thymidine kinase and other biochemical parameters with the purpose of identifying combination of variables which will give optimal prognostic information. Methods. The prognostic factors have been evaluated in 112 previously untreated patients with multiple myeloma. The mean age of patients included in prospective study was 66 years and the median survival was 23.5 months. The following pre-treatment characteristic were evaluated: 1) clinical features, 2) peripheral blood parameters, 3) serum biochemical data such as urea, calcium, beta2-microglobulin, thymidine kinase, 3) electrophoretic data and 4) percentage of bone marrow plasma cells. Patients were treated with standard melphalane and prednisone therapy. Results. Univariate survival analysis showed that the following parameters had a significant effect on survival: performance status, age, blood haemoglobin, platelet number, serum urea, creatinine, calcium, LDH, beta2-microglobulin, thymidine kinase, albumin, monoclonal IgA, policlonal immunoglubulins (IgG, IgA, IgM) and urinary monoclonal immunoglobulin level. The prognostic value of these variables was short-term. (Abstract truncated at 2000 characters).
Izvleček		Izhodišča. Za izbor ustreznega načina zdravljenja diseminiranega plazmocitoma (DP) je pomembna poprejšnja ocena prognoze. Stopenjska razvrstitev DP po Durie in Salmonu in koncentracija beta2-mikroglobulina v serumu sta kazalnika, ki se zaradi lahke dostopnosti najbolj pogosto uporabljata za oceno prognoze. Oba odražata predvsem tumorsko maso, ne upoštevata pa hitrosti rasti klona plazmocitomskih celic. Ta je pomemhen neodvisen prognostični dejavnik, ki ga najbolje opredelimo z indeksom označitve. Glede na to, da je ta preiskava zamudna in prezahtevna za splošno rabo, je za oceno hitrosti rasti klona plazmocitomskih celic enostavnejša določitev aktivnosti timidin kinaze v serumu. Cilj naše raziskave je bil oceniti prognostični pomen aktivnosti timidin kinaze v serumu in drugih biokemičnih kazalnikov ter poiskati optimalno kombinacijo kazalnikov za oceno prognoze DP. Metode. V prospektivni raziskavi smo ocenili prognostične dejavnike pri 112 bolnikih z DP. Bolniki so bili v povprečju stari 66 let. Mediana preživetja je bila 23,5 meseca. Pri vsakem bolniku smo pred začetkom zdravljenja zbrali naslednje podatke: 1. klinične kazalnike, 2. izsledke krvne slike, 3. biokemične kazalnike v krvi, npr. urea, kalcij, beta2-mikroglobulin, timidin kinaza, 4. izsledke elektroforeze seruma ter urina in 5. oceno deleža plazmocitomskih celic v kostnem mozgu. Bolnike smo zdravili na običajen način z melfalanom in prednisonom. Rezultati. Z univariatno analizo smo ugotovili povezanost preživetja z naslednjimi spremenljivkami: bolnikova fizična zmogljivost, starost bolnika, koncentracija hemoglobina, število trombocitov v krvi, sečnina, kreatinin, kalcij, LDH, beta2-mikroglobulin, timidin kinaza, albumin, monoklonski IgA, poliklonski imunoglobulini (IgG, IgA, IgM) v serumu in količina v urinu izločenega monoklonskega imunoglobulina. Naštete spremenljivke so pomembne predvsem za oceno preživetja v prvem letu po ugotovitvi bolezni. (Izvleček skrajšan pri 2000 znakih).
Deskriptorji		MULTIPLE MYELOMA UREA THYMIDINE KINASE PROGNOSIS PROSPECTIVE STUDIES