c-Myc与Bcl-2基因表达在新诊断多发性骨髓瘤患者疗效及预后评估中的临床意义OA

Objective To investigate the relationship of the expression of c-Myc and Bcl-2 genes in the bone marrow of patients with newly diagnosed multiple myeloma(NDMM)with their clinical characteristics,therapeutic efficacy,and prognosis.Methods A retrospective analysis was conducted on the clinical data of 60 patients with NDMM admitted to the 980th Hospital of the Joint Logistic Support Force of the PLA from January 2020 to December 2024.The study group included 20 patients with both c-Myc and Bcl-2 genes expressed,while the control group consisted of 40 patients with neither gene expressed.Both groups received the standard Bortezomib,Lenalidomide,and Dexamethasone(VRd)regimen.The general clinical characteristics and therapeutic efficacy of the two groups were compared.Kaplan-Meier survival analysis was performed using GraphPad Prism 11.0 software,and multivariate Cox regression analysis was used to identify the factors influencing overall survival(OS)and progression-free survival(PFS).The expression of c-Myc and Bcl-2 genes in NDMM patients was dynamically analyzed after the follow-up period.Results The proportions of anemia and abnormal renal function in the study group,as well as the levels of lactate dehydrogenase and β2-microglobulin,were all higher than those in the control group(P<0.05).There was no significant difference in the total response rate after treatment with VRd regimen between the two groups(P>0.05).The median OS(14.7 months vs.21.6 months)and PFS(7.6 months vs.13.9 months)of the study group were shorter than those of the control group(P<0.05).Anemia was an independent adverse prognostic factor for OS in patients with NDMM(P<0.05).After a follow-up period of 4.8 to 56.0 months,among the 12 patients(60%)in the study group whose c-Myc and Bcl-2 gene expressions became negative(negative for both),6(50%)showed re-expression of both genes(positive for both),accompanied by clinical recurrence.Conclusion The expression of c-Myc and Bcl-2 genes is associated with more unfavorable clinical characteristics,lower treatment response,and higher recurrence risk in patients with NDMM.Dynamic monitoring shows that the expression of these two genes becomes negative during remission and reappears at recurrence,suggesting that they may be key molecules driving disease progression and recurrence.