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IL-6促进瘤细胞生长和溶骨，血清IL-6及可溶性IL-6受体增高提示预后不良；血清IL-1β、CD56升高也提示预后不良。
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（五）细胞遗传学和分子生物学标记
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13q-, 13q（del13), 11q-, t(4;14), K-ras突变，P53突变或缺失预后差。
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（六）其他预后因素
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多药耐药基因（MDR）表达与化疗耐药有关，CRP水平与IL-6水平正相关，LDH反映肿瘤量，而IL-2升高是预后良好的指标。
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【思考题】
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1．国内多发性骨髓瘤诊断标准是什么？
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2．多发性骨髓瘤如何分期？
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3．多发性骨髓瘤的治疗进展如何？
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4．如何评价多发性骨髓瘤治疗疗效？
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参考文献
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[2] Greco C, D’A gnano I, Vitelli G, et al. c2MYC deregulation is involved in melphalan resistance of multiple myeloma: role of PDGF2BB. Int J Immunopathol Pharmacol, 2006, 19(1)
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[3] 张之南，沈悌．血液病诊断及疗效标准（第3版）．北京：科学出版社，2007
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[4] 张之南，杨天楹，郝玉书．血液病学．北京：人民卫生出版社，2003
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[5] 侯建，傅卫军．多发性骨髓瘤及其相关疾病．上海：上海科学技术出版社，2002
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[9] Bauernhofer T, Kuss I, Henderson B, et al. Preferential apoptosis of CD56 dim natural killer cell subset in patients with cancer. Eur J Immunol, 2003, 33(l)
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[10] Hideshima T, Chauhan D, Shima Y, et al. Thalidomide and its analogs overcome drug resistance of human multiple myeloma cells to conventional therapy. Blood, 2000, 96(9)
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[12] Richardsonp G, Schlossman RL, Weller E, et al. Immunomodulatory drug CC-5013 overcomes drug resistance and is well tolerated in patients with relapsed multiple myeloma. Blood, 2002, 100(9)
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[13] Musto P, Falcome A, Sanpaolo G, et al. Bortezomib for progressive myeloma after autologous stem cell transplantation and thalidomide. Leuk Res, 2006, 30(3)
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[14] Hussein MA, Saleh M, Ravandi F, et al. Phase 2 study of arsenic trioxide in patients with releapsed or refractroy multiple myeloma. Br J Haematol, 2004, 125(4)
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