Multiple myeloma
Multiple myeloma
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DOI：
10.1016/s0140-6736(14)60493-1
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发表时间：
2015-05-30
期刊：
影响因子：
168.9
通讯作者：
Bornhaeuser, Martin
中科院分区：
文献类型：
--
作者：
Roellig, Christoph;Knop, Stefan;Bornhaeuser, Martin
多发性骨髓瘤是一种恶性疾病，其特征在于骨髓中克隆性浆细胞的增殖，并且通常伴有在血清或尿液中可检测到的单克隆免疫球蛋白的分泌。对恶性浆细胞和骨髓小生境之间的微环境相互作用及其在疾病进展和获得治疗抗性中的作用的理解增加，有助于开发与细胞抑制疗法组合使用的新型治疗药物。随着自体干细胞移植和支持性治疗的进步，蛋白酶体抑制剂和免疫调节药物等新型药物的使用在过去几年中大大提高了反应率和生存率。目前的临床研究重点是治疗效果和生活质量之间的平衡、治疗选择的最佳顺序、多模式治疗的长期缓解和潜在治愈问题、高危闷烧骨髓瘤的先发制人的治疗以及维持的作用。正在进行的临床试验的即将到来的结果，以及一系列有前途的新治疗方法，为未来骨髓瘤患者的预后持续改善带来了希望。
Multiple myeloma is a malignant disease characterised by proliferation of clonal plasma cells in the bone marrow and typically accompanied by the secretion of monoclonal immunoglobulins that are detectable in the serum or urine. Increased understanding of the microenvironmental interactions between malignant plasma cells and the bone marrow niche, and their role in disease progression and acquisition of therapy resistance, has helped the development of novel therapeutic drugs for use in combination with cytostatic therapy. Together with autologous stem cell transplantation and advances in supportive care, the use of novel drugs such as proteasome inhibitors and immunomodulatory drugs has increased response rates and survival substantially in the past several years. Present clinical research focuses on the balance between treatment efficacy and quality of life, the optimum sequencing of treatment options, the question of long-term remission and potential cure by multimodal treatment, the pre-emptive treatment of high-risk smouldering myeloma, and the role of maintenance. Upcoming results of ongoing clinical trials, together with a pipeline of promising new treatments, raise the hope for continuous improvements in the prognosis of patients with myeloma in the future.