多发性神经病伴单克隆免疫球蛋白病的癌变

来源 :世界核心医学期刊文摘(神经病学分册) | 被引量 : 0次 | 上传用户:lujun3
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Objective: To assess the frequency of hematologic malignancies at diagnosis a nd to determine the incidence and predictors of malignant transformation during follow- up in patients with polyneuropathy associated with monoclonal gammopath y. Methods: Potential predictors of malignant transformation from medical histor y, hematologic, neurologic, and laboratory examination performed each 6 months w ere evaluated by univariable and multivariable Cox proportional hazard analysis. Results: Of 193 patients with polyneuropathy associated with monoclonal gammopa thy, 17 patients had a hematologic malignancy at diagnosis. The incidence rate o f malignant transformation in 176 patients without a malignancy at diagnosis was 2.7/100 patient years. Weight loss, progression of the polyneuropathy, unexplai ned fever or night sweats, and M- protein level were independent predictors. Co nclusions: Since hematologic malignancies occur frequently in polyneuropathy ass ociated with monoclonal gammopathy, the authors suggest that all patients should be screened at diagnosis and subsequently during follow- up if malignant trans formation is suspected. Objective: To assess the frequency of hematologic malignancies at diagnosis a nd to determine the incidence and predictors of malignant transformation during follow-up in patients with polyneuropathy associated with monoclonal gammopath y. Methods: Potential predictors of malignant transformation from medical histor y, hematologic, neurologic, and laboratory examination performed each 6 months w ere evaluated by univariable and multivariable Cox proportional hazard analysis. Results: Of 193 patients with polyneuropathy associated with monoclonal gammopa thy, 17 patients had a hematologic malignancy at diagnosis. The incidence rate of malignant transformation in 176 patients without a malignancy at diagnosis was 2.7 / 100 patient years. Weight loss, progression of the polyneuropathy, unexplai ned fever or night sweats, and M-protein level were independent predictors. Co nclusions: Since hematologic malignancies occur frequently in polyneuropathy ass ociated with monoclonal gammopathy, the authors suggest that all patients should be screened at diagnosis and succeeded during follow-up if malignant trans formation is suspected.
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