Sirohi Bhawna, Powles Ray
Institute of Cancer Research and Royal Marsden NHS Trust, Downs Road, Sutton, Surrey SM2 5PT, UK.
Lancet. 2004 Mar 13;363(9412):875-87. doi: 10.1016/S0140-6736(04)15736-X.
Multiple myeloma is a malignant disease of plasma cells that manifests as one or more of lytic bone lesions, monoclonal protein in the blood or urine, and disease in the bone marrow. Treatment for myeloma has changed beyond recognition in the past decade, and now includes state of the art supportive treatment and infusional chemotherapy courses, followed for younger patients by high-dose melphalan and an autologous transplant. Patients younger than 70 years can now expect a doubling of median survival to 5 years, a 20% chance of surviving longer than 10 years, and a 50% chance of attaining complete morphological and biochemical remission. Bisphosphonate control of bone disease is essential. Exploitation of the understanding of the biology of myeloma has led to the development of biological treatments, such as thalidomide, CC-5013, and bortezomib, which target the myeloma cell and the bone-marrow microenvironment, which plays a crucial part in the disease's pathogenesis. These treatments will hold the key to future success.
多发性骨髓瘤是一种浆细胞恶性疾病，表现为溶骨性骨病变、血液或尿液中的单克隆蛋白以及骨髓病变中的一种或多种。在过去十年中，骨髓瘤的治疗发生了翻天覆地的变化，现在包括先进的支持性治疗和输注化疗疗程，对于年轻患者，随后进行大剂量美法仑和自体移植。70岁以下的患者现在预期中位生存期可翻倍至5年，有20%的机会存活超过10年，有50%的机会实现完全形态学和生化缓解。双膦酸盐对骨病的控制至关重要。对骨髓瘤生物学的深入理解促使了生物治疗的发展，如沙利度胺、CC - 5013和硼替佐米，这些药物靶向骨髓瘤细胞和在疾病发病机制中起关键作用的骨髓微环境。这些治疗将是未来成功的关键。
