多発性骨髄腫 の 診断 と 治療: レビュー
Andrew J Cowan1,2,3, Damian J Green1,2,3, Mary Kwok3,4
1Division of Medical Oncology, Department of Medicine, University of Washington, Seattle.
JAMA
|February 1, 2022
まとめ
多発性骨髄腫は 毎年数千人に診断される 骨髄癌です 標準的な治療は プロテアソーム阻害剤,免疫調節剤,デキサメタゾンで 生存率を改善します.
科学分野:
- 血液学的悪性腫瘍
- 腫瘍学
- プラズマ細胞疾患
背景:
- 多発性骨髄腫は,骨髄内の血細胞の癌である.
- 骨の損傷,腎臓の損傷,貧血,高カルシウム症を引き起こす可能性があります.
- 米国では推定34,920人,世界中で推定588,161人が毎年診断されています.
研究 の 目的:
- 多発性骨髄腫の診断基準と現在の標準治療法を概説する.
- 新しい治療法が患者に与える影響を 強調するためです
主な方法:
- 診断には血液検査 (血球,クレアチニン,カルシウム,自由光鎖),血清タンパク質電泳検査,尿タンパク質電泳検査,骨格画像検査が含まれます.
- 改訂された国際ステージングシステムは 生存の予測のためのバイオマーカーと遺伝的特徴を統合しています
- 標準的誘導療法には,ボルテゾミブ,レナリドミド,デキサメタゾンが含まれています.
主要な成果:
- 診断時に患者の73%は貧血,79%は骨疾患,19%は腎臓損傷があります.
- ステージIの患者の5年生存率は82%です
- 標準的誘導療法では,平均41ヶ月までの無進行生存期間が延長されます.
結論:
- 新たに診断された多発性骨髄腫は,バイオマーカーと画像検査を含む包括的な評価を必要とします.
- 誘導療法,幹細胞移植,維持療法を含む現在の標準治療は,患者の予後を大幅に改善します.
- 世界中で毎年約15万5688人が 多発性骨髄腫と診断されています
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