多发性髓瘤的进展情况
11st Department of Internal Medicine, division of Hematology, AHEPA University Hospital, Thessaloniki, Greece. ehatjiharissi@gmail.com.
Hellenic journal of nuclear medicine
|September 2, 2023
概括
多发性髓瘤 (MM) 是一种复杂的血液癌症. 早期的阶段,如未知意义的单克隆性骨髓炎 (MGUS) 和燃烧的多发性骨髓瘤 (SMM),有进展到MM的风险,需要仔细监测和治疗策略.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 癌症生物学 癌症生物学
背景情况:
- 多发性骨髓瘤 (MM) 是克隆性血细胞的瘤性疾病,起源于未知意义的单克隆性骨髓瘤病变 (MGUS),并通过燃烧的多发性骨髓瘤 (SMM) 进展.
- MGUS的每年进展率为1%的MM,而SMM的每年进展率为10%,这突显了疾病进展的持续风险.
- 毫米是由克隆性血细胞增殖导致末端器官损伤或髓瘤定义事件,其特点是遗传复杂性和临床多样性.
研究的目的:
- 提供多发性骨髓瘤的概述,包括其前体阶段和诊断标准.
- 讨论当前的预测工具,如修订的国际分期系统 (R-ISS).
- 概述新诊断和复发/耐药多发性骨髓瘤的标准治疗方法.
主要方法:
- 关于多发性骨髓瘤发病,诊断和治疗的当前文献的综述.
- 讨论移植合格和不合格患者的标准护理 (SoC) 方案.
- 对复发性/耐药性疾病的治疗策略的探索.
主要成果:
- 修订后的国际分期系统 (R-ISS) 用于新诊断患者的预后.
- 适合移植的患者的标准护理包括诱导疗法,自身干细胞移植 (ASCT) 和维护.
- 诱导疗法通常包括蛋白酶体抑制剂,免疫调节药物和/或CD38抗体与德克萨米他.
结论:
- 尽管有显著的治疗进展改善了预后,多发性骨髓瘤仍然无法治愈,经常复发.
- 复发性/耐药性MM的治疗选择是复杂的,因为有各种免疫治疗剂和新药组合.
- 持续的研究和不断变化的治疗场景需要一种细微的方法来有效地管理多发性骨髓瘤.
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