CD45在初诊多发性骨髓瘤患者的表达及预后判断中的意义

OBJECTIVE: To explore the expression of CD45 in newly diagnosed multiple myeloma (MM) and its relationship with clinical efficacy and prognosis. METHODS: This study retrospectively analyzed expression and distribution of CD45 in 130 cases of newly diagnosed MM, comparing clinical efficacy and prognosis in CD45(+)/CD45(−) groups. RESULTS: ①The CD45(+) group was 33 cases (25.38%), and CD45(−) group was 97 cases (74.62%). ②The objective remission rate (ORR) of CD45(+) and CD45(−)group was 33.33% and 64.95%, respectively. The difference was statistically significant (P=0.002). For patients in Bortezomib regimen, the ORR of CD45(+) and CD45(−) group was 35.71% and 66.25%, respectively. The difference was statistically significant (P=0.005). ③The median progress free survival (PFS) of CD45(+) group and CD45(−) group was 29.8 (95%CI 10.0–59.0) months vs 34.5 (95%CI 6.0–69.0) months (χ(2)=14.59, P<0.001) and the median overall survival (OS) was 32.5 (95%CI 10.0–68.0) months vs 37.6 (95%CI 6.0–78.0) months (χ(2)=11.42, P=0.001), respectively. Among the patients in bortezomib regimen, The median PFS and median OS of CD45 (+) group and CD45(−) group were 30.3 (95%CI 10.0–59.0) months vs 36.3 (95%CI 6.0–69.0) months (χ(2)=14.75, P=0.001) and 34.0 (95%CI 10.0–68.0) months vs 39.5 (95%CI 6.0–78.0) months (χ(2)=10.62, P=0.001). ④Cox risk regression model analysis showed that serum creatinine≥176.8 µmol/L (HR=5.078, 95%CI 1.744–14.723, P=0.001), CD45 positive (HR=14.504, 95%CI 0.168–0.42, P=0.001), LDH≥220 IU/L (HR=1.308, 95%CI 1.16–2.417, P=0.015) were independent risk prognostic factors. CONCLUSION: CD45 expression is a risk prognostic factor of MM patients. Bortezomib did not improve the poor prognosis of CD45(+) MM patients.