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多发性骨髓瘤(multiple myeloma,MM)是以骨髓中浆细胞克隆性增生,并分泌单克隆球蛋白为特征的一种恶性肿瘤。尽管近十年来新药的应用使骨髓瘤预后显著改善,但不同患者在疾病进程、治疗反应和生存期上仍显示出很大的异质性。在治疗选择越来越多的今天,如何对患者进行准确的预后判断,进行个体化治疗是MM诊治中的关键问题。本文就MM预后分层及分层治疗策略方面的最新进展总结如下。1 MM的预后指标当前大多数MM预后指标总结来自于既往以烷化剂为基础后续是否进行造血干细胞移植的治疗方案。一些新药改变了传统意义上的不良预后
Multiple myeloma (MM) is a malignant tumor characterized by clonally proliferating plasma cells in the bone marrow and secreting monoclonal globulin. Despite the dramatic improvement in the prognosis of myeloma in the last decade, the use of new drugs has shown significant heterogeneity in disease progression, treatment response, and survival. In the treatment of more and more choices today, how to accurately predict the prognosis of patients, individualized treatment is the key issue in the diagnosis and treatment of MM. This article summarizes the latest advances in MM prognosis stratification and stratified treatment strategies. 1 MM prognostic indicators Most of the current MM prognosis indicators from the previous alkylating agent based on the follow-up whether the treatment of hematopoietic stem cell transplantation. Some new drugs have changed the traditional sense of poor prognosis