Reece Donna E
Princess Margaret Hospital, 610 University Ave., Ste. 5-207, Toronto, ON M5G 2M9, Canada.
Hematology Am Soc Hematol Educ Program. 2005:353-9. doi: 10.1182/asheducation-2005.1.353.
The management of multiple myeloma is rapidly changing. Cytogenetic, molecular and proteomic techniques have led to a better understanding of the pathophysiology of this heterogeneous malignancy. Novel agents designed to interrupt myeloma growth and survival pathways have entered into clinical usage with unprecedented speed, while new prognostic systems based on clinical and biologic features, such as cytogenetic abnormalities, have been developed. A plethora of clinical trials have been initiated utilizing novel agents, alone or in conjunction with established modalities such as conventional cytotoxic agents and stem cell transplantation. These newer treatments have increased the antitumor response rates in this disease and have provided options for patients whose disease has become resistant to conventional therapy. A major challenge is to define the optimal use of these new agents and combinations in order to significantly impact the natural history of myeloma.
多发性骨髓瘤的治疗正在迅速变化。细胞遗传学、分子和蛋白质组学技术使人们对这种异质性恶性肿瘤的病理生理学有了更好的理解。旨在阻断骨髓瘤生长和生存途径的新型药物以前所未有的速度进入临床应用，同时基于细胞遗传学异常等临床和生物学特征的新预后系统也已开发出来。大量临床试验已启动，使用新型药物单独或与传统细胞毒性药物和干细胞移植等既定治疗方式联合使用。这些新疗法提高了该疾病的抗肿瘤反应率，并为疾病对传统治疗产生耐药性的患者提供了选择。一个主要挑战是确定这些新药及其组合的最佳使用方式，以便对骨髓瘤的自然病程产生重大影响。
