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Clinical Characteristics and Risk Factors for Pleural Effusion in Patients with Multiple Myeloma
International Journal of General Medicine ( IF 2.1 ) Pub Date : 2021-02-25 , DOI: 10.2147/ijgm.s300337 Yu Kang 1 , Zi-Liang Hou 2 , Guang-Zhong Yang 3 , Xiao-Juan Wang 1 , Wen-Ming Chen 3 , Huan-Zhong Shi 4
International Journal of General Medicine ( IF 2.1 ) Pub Date : 2021-02-25 , DOI: 10.2147/ijgm.s300337 Yu Kang 1 , Zi-Liang Hou 2 , Guang-Zhong Yang 3 , Xiao-Juan Wang 1 , Wen-Ming Chen 3 , Huan-Zhong Shi 4
Affiliation
Purpose: Pleural effusion (PE) is prevalent in “real-life” populations of multiple myeloma (MM), a common hematologic malignancy. Development of PE likely has prognostic implications. The aim of this study was to investigate the characteristics and identify risk factors for occurrence of PE in MM.
Patients and Methods: We reviewed electronic medical records of 907 patients diagnosed with MM.
Results: Incidence of PE in MM patients was 42.7%. Small and bilateral PE in most cases. PE developed in all MM subtypes, the median time from diagnosis of multiple myeloma to pleural effusion was 6.8 months (range 0.8– 33.6 months). Patients with PE showed worse survival than those without PE (unadjusted hazard ratio with 95% confidence interval: 2.249 [1.774– 2.852]). No difference in survival was found between patients with small PE and those with moderate to large PE (unadjusted HR, 1.402; 95% CI, 1.037– 1.896). Plasma cell proportion (OR, 1.373; 95% CI, 1.153– 1.634; P = 0.009) and amyloidosis (OR, 1.791; 95% CI, 1.408– 2.279; P = 0.024) were risk factors for the occurrence of PE at the initial diagnosis of MM. Plasma cell proportion (OR, 1.853; 95% CI, 1.451– 2.368; P = 0.038), pneumonia (OR, 1.309; 95% CI, 1.143– 1.498; P = 0.008) and heart failure (OR, 1.815; 95% CI, 1.387– 2.374; P = 0.031) were risk factors for the occurrence of PE at relapse of MM.
Conclusion: The incidence of PE in MM patients is notable and PE can occur in all MM subtypes. PE indicates a poor prognosis, even small amounts of effusion. PE is a problem worthy of attention, especially in patients with high plasma cell proportion, amyloidosis or complicated with pneumonia and heart failure.
Keywords: pleural effusion, multiple myeloma, incidence, risk factors, overall survival
中文翻译：
多发性骨髓瘤患者胸腔积液的临床特征和危险因素
目的：胸腔积液 (PE) 在“现实生活”中多发性骨髓瘤 (MM) 人群中普遍存在，MM 是一种常见的血液系统恶性肿瘤。PE的发展可能具有预后意义。本研究的目的是调查 MM 发生 PE 的特征并确定危险因素。
患者和方法：我们回顾了 907 名诊断为 MM 的患者的电子病历。
结果：MM 患者 PE 的发生率为 42.7%。大多数情况下是小的双侧 PE。所有 MM 亚型均出现 PE，从诊断多发性骨髓瘤到胸腔积液的中位时间为 6.8 个月（范围 0.8-33.6 个月）。PE 患者的生存率比没有 PE 的患者差（未经调整的风险比，95% 置信区间：2.249 [1.774-2.852]）。小 PE 患者与中至大 PE 患者的生存率没有差异（未经调整的 HR，1.402；95% CI，1.037-1.896）。浆细胞比例（OR，1.373；95% CI，1.153-1.634；P = 0.009）和淀粉样变性（OR，1.791；95% CI，1.408-2.279；P = 0.024）是最初发生 PE 的危险因素MM的诊断。浆细胞比例（OR，1.853；95% CI，1.451–2.368；P = 0.038），肺炎（OR，1.309；95% CI，1.143–1.498；P = 0。
结论： MM患者PE发生率显着，所有MM亚型均可发生PE。PE 提示预后不良，即使是少量积液。PE是一个值得关注的问题，尤其是浆细胞比例高、淀粉样变性或并发肺炎、心力衰竭的患者。
【关键词】：胸腔积液 多发性骨髓瘤 发病率 危险因素 总生存期
更新日期：2021-04-20
Patients and Methods: We reviewed electronic medical records of 907 patients diagnosed with MM.
Results: Incidence of PE in MM patients was 42.7%. Small and bilateral PE in most cases. PE developed in all MM subtypes, the median time from diagnosis of multiple myeloma to pleural effusion was 6.8 months (range 0.8– 33.6 months). Patients with PE showed worse survival than those without PE (unadjusted hazard ratio with 95% confidence interval: 2.249 [1.774– 2.852]). No difference in survival was found between patients with small PE and those with moderate to large PE (unadjusted HR, 1.402; 95% CI, 1.037– 1.896). Plasma cell proportion (OR, 1.373; 95% CI, 1.153– 1.634; P = 0.009) and amyloidosis (OR, 1.791; 95% CI, 1.408– 2.279; P = 0.024) were risk factors for the occurrence of PE at the initial diagnosis of MM. Plasma cell proportion (OR, 1.853; 95% CI, 1.451– 2.368; P = 0.038), pneumonia (OR, 1.309; 95% CI, 1.143– 1.498; P = 0.008) and heart failure (OR, 1.815; 95% CI, 1.387– 2.374; P = 0.031) were risk factors for the occurrence of PE at relapse of MM.
Conclusion: The incidence of PE in MM patients is notable and PE can occur in all MM subtypes. PE indicates a poor prognosis, even small amounts of effusion. PE is a problem worthy of attention, especially in patients with high plasma cell proportion, amyloidosis or complicated with pneumonia and heart failure.
Keywords: pleural effusion, multiple myeloma, incidence, risk factors, overall survival
中文翻译：
多发性骨髓瘤患者胸腔积液的临床特征和危险因素
目的：胸腔积液 (PE) 在“现实生活”中多发性骨髓瘤 (MM) 人群中普遍存在，MM 是一种常见的血液系统恶性肿瘤。PE的发展可能具有预后意义。本研究的目的是调查 MM 发生 PE 的特征并确定危险因素。
患者和方法：我们回顾了 907 名诊断为 MM 的患者的电子病历。
结果：MM 患者 PE 的发生率为 42.7%。大多数情况下是小的双侧 PE。所有 MM 亚型均出现 PE，从诊断多发性骨髓瘤到胸腔积液的中位时间为 6.8 个月（范围 0.8-33.6 个月）。PE 患者的生存率比没有 PE 的患者差（未经调整的风险比，95% 置信区间：2.249 [1.774-2.852]）。小 PE 患者与中至大 PE 患者的生存率没有差异（未经调整的 HR，1.402；95% CI，1.037-1.896）。浆细胞比例（OR，1.373；95% CI，1.153-1.634；P = 0.009）和淀粉样变性（OR，1.791；95% CI，1.408-2.279；P = 0.024）是最初发生 PE 的危险因素MM的诊断。浆细胞比例（OR，1.853；95% CI，1.451–2.368；P = 0.038），肺炎（OR，1.309；95% CI，1.143–1.498；P = 0。
结论： MM患者PE发生率显着，所有MM亚型均可发生PE。PE 提示预后不良，即使是少量积液。PE是一个值得关注的问题，尤其是浆细胞比例高、淀粉样变性或并发肺炎、心力衰竭的患者。
【关键词】：胸腔积液 多发性骨髓瘤 发病率 危险因素 总生存期
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