摘要
多发性骨髓瘤（MM）是一种反复复发的不可治愈的恶性浆细胞肿瘤,硼替佐米、来那度胺等靶向新药的应用明显延长了其生存期。MM的全程治疗包括诱导缓解治疗、巩固维持治疗和复发后再诱导。不同作用机制的抗骨髓瘤药物组成的三药方案为MM诱导缓解治疗的基石,硼替佐米基础方案为骨髓瘤合并肾损害患者的首选方案。小于65岁或年轻患者新诊断MM患者建议病情缓解后接受自体干细胞移植治疗,以来那度胺或硼替佐米作为维持治疗。复发难治的MM患者可以给予以前未用过的化疗方案治疗或接受新药临床试验。CD138单克隆抗体或CAR-T等新疗法等新药的应用使MM的治疗跨入了免疫靶向治疗时代,将进一步加深MM患者的缓解深度并改善生存。
Multiple myeloma（MM） is an incurable plasma cell malignancy that repeatedly relapses.The use of targeted drugs such as bortezomib and lenalidomide has significantly prolonged patient survival. The overall treatment of MM includes induction of remission chemotherapy,consolidation of maintenance therapy,and induction chemotherapy again after relapse. The regimen composed of three drugs with different anti-myeloma mechanisms is the cornerstone of MM-induced remission therapy,and the bortezomib-based regimen is the preferable protocol for patients with renal impairment. Newly diagnosed MM patients younger than 65 years of age are advised to undergo autologous stem cell transplantation after remission,with lenalidomide or bortezomib as maintenance therapy. Patients with relapsed and refractory MM can be given previously used chemotherapy regimens or receive new drug clinical trials. The use of CD138 monoclonal antibodies or new therapies such as Car-T has enabled the treatment of MM to step into the era of targeted immune therapy,which will further deepen the remission and improve survival of MM patients.
作者
王林月
黄仲夏
WANG Lin-yue;HU ANG Zhong-xia(West Campus of Beijing Chaoyang Hospital,Capital Medical University,Beijing 100043,China)
出处
《肿瘤学杂志》
CAS
2018年第10期952-956,共5页
Journal of Chinese Oncology
基金
北京市石景山区医学重点扶持专科建设项目(20170006)
关键词
多发性骨髓瘤
缓解
复发
靶向治疗
免疫治疗
multiple myeloma
remission
relapses
targeted therapy
immunotherapy
