多发性骨髓瘤诊断及治疗研究现状

马 冰洁, 宁 熙, 周 涛
昆明医科大学第二附属医院

摘要

多发性骨髓瘤(MultipleMyeloma,MM)是血液系统第二常见的恶性肿瘤,疾病初期通常无明显症状,随病情进展可能演变为复发､难治的情况｡随着对MM生物学特性及临床研究的不断深入,其治疗方式越来越多样及个体化｡随着蛋白酶体抑制剂､免疫调节剂､单克隆抗体､嵌合抗原受体T细胞(CAR-T)疗法及新药物的研发,MM患者的生存期及预后发生了显著改善｡本文结合美国国立综合癌症网(NCCN)更新的2023年第3版MM的诊治指南对本病的诊断及治疗内容进行综述｡

关键词

多发性骨髓瘤;NCCN;诊断;治疗

参考

[1]SIEGELRL,MILLERKD,JEMALA.Cancerstatistics,2017[J/OL].CA:ACancerJournalforClinicians,2017,67(1):7-30.DOI:10.3322/caac.21387.[2]SIEGELRL,MILLERKD,WAGLENS,etal.Cancerstatistics,2023[J/OL].CA:ACancerJournalforClinicians,2023,73(1):17-48.DOI:10.3322/caac.21763.[3]COWANAJ,GREENDJ,KWOKM,etal.DiagnosisandManagementofMultipleMyeloma:AReview[J/OL].JAMA,2022,327(5):464.DOI:10.1001/jama.2022.0003.[4]CAVOM,TERPOSE,NANNIC,etal.Roleof18F-FDGPET/CTinthediagnosisandmanagementofmultiplemyelomaandotherplasmacelldisorders:aconsensusstatementbytheInternationalMyelomaWorkingGroup[J/OL].TheLancetOncology,2017,18(4):e206-e217.DOI:10.1016/S1470-2045(17)30189-4.[5]SATHES,SELENEII,JOSEJ,etal.Asystematicreviewonsmolderingmultiplemyeloma:Whethertreatmentisbeneficial.[J/OL].JournalofClinicalOncology,2022,40(16_suppl):e20029-e20029.DOI:10.1200/JCO.2022.40.16_suppl.e20029.[6]THORSTEINSDÓTTIRS,GÍSLASONGK,ASPELUNDT,etal.Prevalenceofsmolderingmultiplemyelomabasedonnationwidescreening[J/OL].NatureMedicine,2023,29(2):467-472.DOI:10.1038/s41591-022-02183-6.[7]GONSALVESWI,RAJKUMARSV,DISPENZIERIA,etal.QuantificationofCirculatingClonalPlasmaCellsviaMultiparametricFlowCytometryIdentifiesPatientswithSmolderingMultipleMyelomaatHighRiskofProgression[J/OL].Leukemia,2017,31(1):130-135.DOI:10.1038/leu.2016.205.[8]MOREAUP,PYLYPENKOH,GROSICKIS,etal.Subcutaneousversusintravenousadministrationofbortezomibinpatientswithrelapsedmultiplemyeloma:arandomised,phase3,non-inferioritystudy[J/OL].TheLancetOncology,2011,12(5):431-440.DOI:10.1016/S1470-2045(11)70081-X.[9]BARLOGIEB,TRICOTG,ANAISSIEE,etal.ThalidomideandHematopoietic-CellTransplantationforMultipleMyeloma[J/OL].NewEnglandJournalofMedicine,2006,354(10):1021-1030.DOI:10.1056/NEJMoa053583.[10]COVUTF,PINTOR,PARKM,etal.Venousthromboembolism(VTE)inmultiplemyeloma(MM)patientsundergoingautologoushematopoieticcelltransplantation(HCT).[J/OL].JournalofClinicalOncology,2017,35(15_suppl):e19503-e19503.DOI:10.1200/JCO.2017.35.15_suppl.e19503.