Response to 'Evolving M-protein pattern in patients with smoldering multiple myeloma: impact on early progression'.
Response to 'Evolving M-protein pattern in patients with smoldering multiple myeloma: impact on early progression'.
复制标题
对“冒烟型多发性骨髓瘤患者 M 蛋白模式的演变：对早期进展的影响”的回应。
DOI：
10.1038/s41375-018-0155-4
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发表时间：
2018
期刊：
影响因子：
11.4
通讯作者：
Kumar,ShajiK
中科院分区：
文献类型：
--
作者：
Lakshman,Arjun;Ravi,Praful;Rajkumar,SVincent;Kumar,ShajiK
显然，“演变”定义的标准决定了发病率，从诊断SMM开始的时间，以及这种演变模式对症状性MM的诊断能力。我们的定义是非常具体的（大多数演变的患者将在不久后进展为MM），但可能不那么敏感，因为并不是每个发展为MM的患者都经历了可检测的“演变”阶段。因此，有空间来评估“演变”模式的替代定义的敏感性和特异性，以预测进展为症状性MM。大型国际数据库的分析，已经在进行中，将有助于确定最佳方式将“演变”模式纳入SMM的风险分层，使高风险患者可以清楚地认识到，并从及时的治疗中受益。
Obviously, criteria on which “evolving” is defined determines the incidence, the time elapsed from the diagnosis of SMM, and the capability of this evolution pattern to prognosticate symptomatic MM. Our definition is very specific (most of the evolving patients will progress to MM shortly afterwards) but perhaps not so sensitive as it should be because not every patient who developed MM passed through a detectable “evolving” phase. There is room, therefore, to evaluate alternative definitions of “evolving” pattern in terms of sensitivity and specificity to predict progression into symptomatic MM. The analysis of large international databases, already ongoing, would be helpful in the identification of the best way to incorporate the “evolving” pattern into the risk stratification of SMM so that high-risk patients could be clearly recognized and benefited from timely treatment.