Fonseca Rafael, San Miguel Jesus
Mayo Clinic Arizona, 13208 East Shea Boulevard, Collaborative Research Building, 3-006, Scottsdale, AZ 85259-5494, USA.
Hematol Oncol Clin North Am. 2007 Dec;21(6):1115-40, ix. doi: 10.1016/j.hoc.2007.08.010.
The field of multiple myeloma prognostication is replete with studies that have shown the value of independent predictors in determining clinical outcome. It is clear that host factors and factors intrinsic to the cells are the ultimate determinants of prognosis. In the immediate period after diagnosis, those factors related to the host are likely to be more relevant, whereas with passing time factors intrinsic to the cells predominate. At a minimum, we recommend that a comprehensive molecular cytogenetic assessment be performed at diagnosis, together with conventional evaluation, including beta2-microglobulin and albumin. In addition, information on proliferative activity of plasma cells may be of value. The introduction of novel methods of prognostication should be strongly considered in all clinical trials.
多发性骨髓瘤预后领域有大量研究表明，独立预测因素在确定临床结局方面具有重要价值。显然，宿主因素和细胞内在因素是预后的最终决定因素。在诊断后的短期内，那些与宿主相关的因素可能更为重要，而随着时间的推移，细胞内在因素则占主导地位。至少，我们建议在诊断时进行全面的分子细胞遗传学评估，并结合包括β2微球蛋白和白蛋白在内的传统评估。此外，浆细胞增殖活性的信息可能也有价值。在所有临床试验中都应大力考虑引入新的预后评估方法。
