Objective: To evaluate the clinical and prognostic value of prothrombin time (PT) and activated partial thromboplastin time (APTT) in newly diagnosed patients with multiple myeloma (MM).
Methods: The clinical data of 116 newly diagnosed MM patients in the Second Hospital and Third Hospital of Shanxi Medical University from October 2014 to March 2022 were analyzed retrospectively, and the patients were divided into two groups: normal PT and APTT group and prolonged PT or APTT group. The differences in sex, age, classification, staging, bleeding events, laboratory indicators [including hemoglobin (Hb), platelet count (PLT), serum calcium, serum albumin (ALB), lactate dehydrogenase (LDH), serum creatinine and β2-microglobulin], and cytogenetic characteristics between the two groups of patients were compared. The effect of prolonged PT or APTT on survival of patients with MM was analyzed.
Results: Compared with patients in normal PT and APTT group, patients in prolonged PT or APTT group were more likely to experience bleeding events (χ2=5.087, P =0.024), with lower ALB levels (χ2=4.962, P =0.026) and PLT levels (χ2=4.309, P =0.038), and higher serum calcium levels (χ2=5.056, P =0.025). The positive rates of del17p, del13q and 1q21+ in prolonged PT or APTT group were higher than those in normal PT and APTT group, but the difference was not statistically significant (P >0.05). K-M survival analysis showed that the prolonged PT or APTT group had a shorter median progression-free survival (PFS) (P =0.032) and overall survival (OS) (P =0.032). Multivariate Cox analysis showed that prolonged PT or APTT (HR=2.116, 95%CI :1.025-4.372, P =0.043) and age ≥65 years (HR=2.403, 95%CI : 1.195-4.836, P =0.014) were independent risk factor for OS in newly diagnosed MM patients. However, prolonged PT or APTT had no significant effect on PFS of newly diagnosed MM patients (HR=1.162, 95%CI : 0.666-2.026, P =0.597).
Conclusion: Newly diagnosed MM patients with prolonged PT or APTT have worse clinical indicators, shorter PFS and OS. Prolonged PT or APTT is an independent risk factor for OS in MM patients.
题目: 凝血酶原时间和活化部分凝血活酶时间在初诊多发性骨髓瘤患者中的预后价值.
目的: 评估凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）在初诊多发性骨髓瘤（MM）患者中的临床及预后价值。.
方法: 回顾性分析2014年10月至2022年3月在山西医科大学第二医院和第三医院血液科就诊的116例初诊MM患者的临床资料，并将患者分为PT和APTT正常组及PT或APTT延长组。比较两组患者在性别、年龄、分型、分期、出血事件、实验室指标[血红蛋白（Hb）、血小板计数（PLT）、血钙、血清白蛋白（ALB）、乳酸脱氢酶（LDH）、β2-微球蛋白、肌酐）]、细胞遗传学特征等方面的差异，分析PT或APTT延长对MM患者生存的影响。.
结果: 与PT和APTT正常组相比，PT或APTT延长组更容易发生出血事件（χ2=5.087，P =0.024）、具有更低的ALB水平（χ2=4.962，P =0.026）和PLT水平（χ2=4.309，P =0.038），以及更高的血钙水平（χ2=5.056，P =0.025）。PT或APTT延长组del13q、1q21扩增、del17p阳性率高于PT和APTT正常组，但差异无统计学意义（P >0.05）。K-M生存分析显示，PT或APTT延长组具有更短的中位无进展生存期（PFS）（P =0.032）和总生存期（OS）（P =0.032）；多因素Cox分析结果显示，PT或APTT延长（HR=2.116，95%CI : 1.025-4.372，P =0.043）、年龄≥65岁（HR=2.403，95%CI : 1.195-4.836，P =0.014）是影响初诊MM患者OS的独立危险因素；但PT或APTT延长对初诊MM患者的PFS没有明显影 响（HR=1.162，95%CI : 0.666-2.026，P =0.597）。.
结论: PT或APTT延长的初诊MM患者具有更恶化的临床指标、更短的PFS和OS；PT或APTT延长是影响MM患者OS的独立危险因素。.
Keywords: multiple myeloma; prothrombin time; activated partial thromboplastin time; prognosis.