Spinal Tutulumu Olan Multipl Miyelom Hastalarında Cerrahi Uygulanan ve Uygulanmayan Olguların Klinik ve Laboratuvar Özelliklerinin Karşılaştırılması

Öz

Bu çalışmanın amacı, spinal tutulumu bulunan multipl miyelom hastalarında cerrahi uygulanan ve uygulanmayan olguların klinik, demografik ve laboratuvar özelliklerini karşılaştırmaktır. Bu retrospektif, tek merkezli kohort çalışmasına 2013–2025 yılları arasında Özel Ümit Hastanesi’nde tanı almış toplam 46 spinal tutulumlu multiple miyelom hastası dahil edildi. On sekiz hastaya cerrahi tedavi uygulanırken, 28 hasta medikal olarak yönetildi. Her iki grupta da yaş, cinsiyet, semptom profili ve laboratuvar parametreleri karşılaştırıldı. Veriler SPSS 25.0 programı ile analiz edildi. Normallik Shapiro–Wilk testiyle değerlendirildi; uygun durumlarda Student t-testi, Mann–Whitney U testi ve ki-kare testleri kullanıldı.  Cerrahi grup ortalama 63,3 ± 6,0 yaş, cerrahi dışı grup ise 67,3 ± 8,7 yaş ortalamasına sahipti. Cerrahi hastalarda başvuru semptomu sıklıkla bel/sırt ağrısı iken, cerrahi dışı grupta yorgunluk, kilo kaybı ve yaygın kas-iskelet ağrıları ön plandaydı. Laboratuvar karşılaştırmalarında üre (p = 0.025), beta-2 mikroglobulin (p = 0.008) ve ISS skorları (p = 0.034) cerrahi dışı grupta anlamlı olarak yüksek bulundu. Bu bulgular, cerrahi yapılmayan hastalarda sistemik hastalık yükünün daha fazla olduğunu göstermektedir. Diğer biyokimyasal parametreler açısından anlamlı fark izlenmedi. Spinal tutulumu olan multipl miyelom hastalarında cerrahi uygulanan olgular genellikle daha düşük sistemik hastalık aktivitesine ve daha iyi böbrek fonksiyonlarına sahiptir. Spinal bölgede erken nörolojik veya ağrı semptomlarının ortaya çıkması, bu hastalarda tanının daha kısa sürede konmasını sağlayabilir.

Anahtar Kelimeler

• multipl miyelom
• spinal tutulum
• beta-2 mikroglobulin
• ISS skoru

Destekleyen Kurum

Bu araştırma, kamu, ticari veya kar amacı gütmeyen herhangi bir finansal destek kuruluşundan özel bir destek almamıştır.

Etik Beyan

Bu çalışma, kurumsal ve ulusal etik kurulların standartlarına ve 1964 Helsinki Bildirgesi’ne uygun olarak yürütülmüştür. Çalışma için Özel Ümit Hastanesi Etik Kurulu’ndan 28.08.2025 tarihli ve 33 sayılı onay alınmıştır.

Comparison of Clinical and Laboratory Characteristics Between Surgically and Non-Surgically Treated Multiple Myeloma Patients with Spinal Involvement

Öz

This study aimed to compare the clinical, demographic, and laboratory characteristics of multiple myeloma patients with spinal involvement who underwent surgical versus non-surgical management.This retrospective, single-center cohort study included 46 multıple myeloma patients with radiologically confirmed spinal involvement who were treated at Private Ümit Hospital between 2013 and 2025. Eighteen patients underwent surgical intervention, while 28 were managed medically. Demographic data, presenting symptoms, and laboratory parameters were compared between groups. Data were analyzed using SPSS 25.0. Normality was assessed by the Shapiro–Wilk test, and appropriate statistical tests (Student’s t-test, Mann–Whitney U, chi-square) were applied. The mean age was 63.3 ± 6.0 years in the surgical group and 67.3 ± 8.7 years in the non-surgical group. Back or low back pain was the most frequent presenting symptom in surgically treated patients, while systemic manifestations such as fatigue, weight loss, and diffuse musculoskeletal pain predominated in the non-surgical group. Laboratory comparisons revealed significantly higher BUN (p = 0.025), beta-2 microglobulin (p = 0.008), and ISS scores (p = 0.034) in the non-surgical cohort, indicating a greater systemic disease burden. No significant intergroup differences were observed in other biochemical parameters. Multiple myeloma patients with spinal involvement who undergo surgery tend to have lower systemic disease activity and better renal function compared to those treated conservatively. The presence of neurological or pain symptoms due to proximity to neural structures may lead to earlier diagnosis in these patients.

Anahtar Kelimeler

• multiple myeloma
• spinal involvement
• beta-2 microglobulin
• international staging system score

Destekleyen Kurum

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Etik Beyan

This study was conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. Ethical approval for this study was obtained from the Ethics Committee of Private Ümit Hospital (Approval No: 33, Date: August 28, 2025).

Kaynakça

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