European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: what to use and when.
European Myeloma Network recommendations on tools for the diagnosis and monitoring of multiple myeloma: what to use and when.
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DOI：
10.3324/haematol.2018.189159
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发表时间：
2018-11
期刊：
影响因子：
10.1
通讯作者：
Engelhardt M
中科院分区：
文献类型：
--
作者：
Caers J;Garderet L;Kortüm KM;O'Dwyer ME;van de Donk NWCJ;Binder M;Dold SM;Gay F;Corre J;Beguin Y;Ludwig H;Larocca A;Driessen C;Dimopoulos MA;Boccadoro M;Gramatzki M;Zweegman S;Einsele H;Cavo M;Goldschmidt H;Sonneveld P;Delforge M;Auner HW;Terpos E;Engelhardt M
多发性骨髓瘤的诊断可能具有挑战性，即使对于经验丰富的医生来说，也需要在骨髓瘤的最终诊断之前，许多学科（骨科，放射学，核医学，放射治疗，血液学和肿瘤学）之间的密切合作。多发性骨髓瘤的定义是基于疾病的临床、生化、组织病理学和放射学标志物的存在。为了达到正确的诊断和准确地描述疾病的特征，在就诊时和随访期间都需要进行特定的测试。这些测试也可以用于预后目的，并用于骨髓瘤患者的随访。分子分析仍然是确定高风险骨髓瘤的关键，并用于更新患者分层，而通过流式细胞术，分子技术和放射学方法进行的微小残留疾病评估提供了有关患者长期结局的额外预后信息。这些关键信息将指导我们在即将进行的临床试验中做出未来的治疗决定。欧洲骨髓瘤网络小组更新了他们关于不同诊断建议的指南，这对于在诊断和随访期间适当使用这些建议应该是有价值的。
The diagnosis of multiple myeloma can be challenging, even for experienced physicians, and requires close collaboration between numerous disciplines (orthopedics, radiology, nuclear medicine, radiation therapy, hematology and oncology) before the final diagnosis of myeloma is made. The definition of multiple myeloma is based on the presence of clinical, biochemical, histopathological, and radiological markers of disease. Specific tests are needed both at presentation and during follow-up in order to reach the correct diagnosis and characterize the disease precisely. These tests can also serve prognostic purposes and are useful for follow-up of myeloma patients. Molecular analyses remain pivotal for defining high-risk myeloma and are used in updated patient stratifications, while minimal residual disease assessment via flow cytometry, molecular techniques and radiological approaches provides additional prognostic information on patients’ long-term outcome. This pivotal information will guide our future treatment decisions in forthcoming clinical trials. The European Myeloma Network group updated their guidelines on different diagnostic recommendations, which should be of value to enable appropriate use of the recommendations both at diagnosis and during follow-up.