多发性骨髓瘤是一种多发性骨髓瘤
Florent Malard1, Paola Neri2, Nizar J Bahlis2
1Sorbonne Université, Centre de Recherche Saint-Antoine INSERM UMRs938, Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Paris, France. florent.malard@inserm.fr.
Nature reviews. Disease primers
|June 27, 2024
概括
多发性骨髓瘤 (MM) 是一种复杂的血液癌症,影响血细胞,在治疗后经常复发. 目前的治疗包括对年轻患者进行干细胞移植,以及针对复发或老年人的新型免疫疗法.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 多发性骨髓瘤 (MM) 是第二常见的血液性恶性瘤,其特征是血细胞增殖和单克隆性免疫球蛋白的产生.
- 尽管MM的发病率越来越高,但由于经常复发和治疗阻断性,MM仍然无法治愈.
- 乳腺癌是一种遗传复杂和异质的疾病,涉及瘤细胞的改变和骨髓微环境的变化.
研究的目的:
- 提供多发性骨髓瘤 (MM) 的概述,包括其诊断,当前的治疗策略和新兴疗法.
- 突出MM治疗的挑战,如疾病异质性和复发.
- 讨论MM管理的不断变化的格局,包括新型免疫疗法.
主要方法:
- 诊断依赖于国际骨髓瘤工作组的标准,包括骨髓透和骨髓瘤定义事件 (CRAB特征或生物标志物).
- 治疗方法根据患者的年龄和健康状况进行分层,符合条件的个体可以进行自身造血细胞移植.
- 对于不适合移植的老年人来说,组合疗法 (达拉图穆马布,莱纳利多米德,德甲) 是最好的.
主要成果:
- 治疗方案包括诱导,巩固 (高剂量梅尔法兰和自身干细胞移植),以及符合条件的患者的维持疗法.
- 复发或耐药的MM病例是根据先前的治疗方法进行管理,并越来越多地使用免疫疗法.
- 新兴的免疫疗法包括双特异性单克隆抗体和嵌合式抗原受体T细胞疗法.
结论:
- 多发性骨髓瘤仍然是一个重大的临床挑战,因为它的复杂性和耐治疗性.
- 治疗策略正在进步,为移植符合条件和不符合条件的患者提供了更好的结果.
- 新型免疫疗法的整合在治疗复发性和耐火性多发性髓瘤方面是一个有前途的前沿.
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