Multiple Myeloma: Future Directions in Autologous Transplantation and Novel Agents
Multiple Myeloma: Future Directions in Autologous Transplantation and Novel Agents
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DOI：
10.1016/j.bbmt.2012.11.002
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发表时间：
2013-01-01
影响因子：
4.3
通讯作者：
McCarthy, Philip L.
中科院分区：
文献类型：
--
作者：
Hari, Parameswaran N.;McCarthy, Philip L.
20世纪90年代的自体造血细胞移植（AHCT）和21世纪初“新型”疗法（如免疫调节剂和蛋白酶体抑制剂）的出现，使多发性骨髓瘤（MM）的治疗取得了令人印象深刻的进展1，2。在前新药时代，治疗模式包括诱导，然后在合格患者中进行计划的AHCT，称为“前期”或早期AHCT，旨在实现更深的疾病缓解和更长的生存期。随着现代诱导治疗结合新药，AHCT的时机和需要越来越多的争论，因为早期AHCT的额外生存获益尚未建立与现代诱导方案。常规移植后巩固和维持是基于AHCT的MM治疗的新趋势。第二代免疫调节剂和蛋白酶体抑制剂、敏感的预后方案和疾病监测技术也在改变治疗前景。在串联BMT会议上的这个会议探讨了MM早期AHCT的相关性和未来，移植后巩固/维持的作用，以及新药开发。
Autologous hematopoietic cell transplantation (AHCT) in the 1990s and the advent of “novel” therapy, such as immune modulators and proteasome inhibitors, in the 2000s have led to impressive gains in the treatment of multiple myeloma (MM) 1, 2. In the prenovel drug era, the therapy paradigm composed of induction followed by planned AHCT in eligible patients, denoted as “upfront” or early AHCT, aimed at achieving a deeper disease response and longer survival. With modern induction therapies incorporating novel drugs, the timing and need for AHCT is increasingly debated because an additional survival benefit for early AHCT has not been established with modern induction regimens. Routine post-transplant consolidation and maintenance are new trends in AHCT-based treatment of MM. Second-generation immune modulators and proteasome inhibitors, sensitive prognostic schema, and disease-monitoring techniques are also changing the treatment landscape. This session at the tandem BMT meetings explores the relevance and future of early AHCT in MM, the role of consolidation/maintenance post-transplant, and new drug development.