Multiple myeloma epidemiology and survival: A unique malignancy.
Multiple myeloma epidemiology and survival: A unique malignancy.
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DOI：
10.1053/j.seminoncol.2016.11.004
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发表时间：
2016-12
影响因子：
4
通讯作者：
Kazandjian D
中科院分区：
文献类型：
--
作者：
Kazandjian D
多发性骨髓瘤（MM）虽然是一种罕见疾病，但却是第二常见的血液恶性肿瘤。它被发现于浆细胞恶液质谱中，始于单克隆丙种球蛋白病，对明显的浆细胞白血病和髓外骨髓瘤的意义未知。 MM 由于其终末器官破坏而与显着的发病率相关。它是一种老年人群疾病，非洲裔美国人的发病率是欧洲裔美国人的两倍。在过去的几十年里，从使用自体干细胞移植开始，随后出现免疫调节药物和蛋白酶体抑制剂等新型治疗方法，多发性骨髓瘤治疗方法取得了进步，改变了该疾病的自然史，从而延长了生存时间。多发性骨髓瘤的诊断、监测和治疗方面的进步至关重要，因为医疗保健方面的其他进步使普通人群的寿命更长。最近推出的新疗法与多发性骨髓瘤监测技术的进步同步进行，即检测微小残留病的极其灵敏的技术的出现。随着药物开发和技术的不断改进，设计入组患者群体的临床试验非常重要，这些患者群体代表包括少数族裔和老年人在内的总体人群，以便可以适当地推断试验结果。本手稿回顾了流行病学的变化、生存率的提高以及在 MM 重要亚组中观察到的健康差异。
Multiple myeloma (MM), although a rare disease, is the second most common hematologic malignancy. It is found in the spectrum of plasma cell dyscrasias which begins with monoclonal gammopathy of unknown significance to overt plasma cell leukemia and extramedullary myeloma. MM is associated with significant morbidity due to its end-organ destruction. It is a disease of the older population and its incidence in the African American population is twice that of the European American population. Improvements in the treatment of MM in the past couple of decades, beginning with the use of autologous stem cell transplantation followed by availability of novel treatments such as immunomodulatory drugs and proteasome inhibitors has transformed the natural history of the disease leading to longer survival times. Advancements in the diagnosis, monitoring, and treatment of MM are of the utmost importance as the general population lives longer due to other improvements in health care. The recent introduction of novel therapies has been paralleled by advancements in the monitoring of MM, namely, by the availability exquisitely sensitive techniques in detecting minimal residual disease. As drug development and technology continues to improve, it will be important to design rationale clinical trials enrolling patient populations which represent the overall population including racial minorities and the elderly so trial results can be appropriately extrapolated. This manuscript reviews the changing epidemiology, the improvements in survival, and the health disparity observed in important subgroups of MM.