Rajkumar S Vincent, Palumbo Antonio
Division of Hematology, Department of Internal Medicine, Mayo Clinic and Foundation, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Hematol Oncol Clin North Am. 2007 Dec;21(6):1141-56, ix-x. doi: 10.1016/j.hoc.2007.08.008.
The treatment of multiple myeloma has changed dramatically in the last decade with the introduction of thalidomide, bortezomib, and lenalidomide. Patients eligible for autologous stem cell transplantation (ASCT) are treated with non-alkylating agent-containing regimens as initial therapy; typically thalidomide-dexamethasone or lenalidomide-dexamethasone. For patients not eligible for ASCT, the current standard of care is melphalan, prednisone, and thalidomide. Ongoing trials will soon assess if combinations including melphalan and prednisone plus bortezomib or MP plus lenalidomide may be considered an attractive option. Patients who have risk factors, such as deletion 13 or translocation t(4;14) or t(14;16), are candidates for novel, more aggressive treatments.
在过去十年中，随着沙利度胺、硼替佐米和来那度胺的引入，多发性骨髓瘤的治疗发生了巨大变化。适合自体干细胞移植（ASCT）的患者，初始治疗采用含非烷化剂的方案；通常是沙利度胺 - 地塞米松或来那度胺 - 地塞米松。对于不适合ASCT的患者，目前的标准治疗方案是美法仑、泼尼松和沙利度胺。正在进行的试验将很快评估包括美法仑和泼尼松加硼替佐米或MP加来那度胺的联合方案是否可被视为一个有吸引力的选择。有风险因素的患者，如13号染色体缺失或t(4;14)或t(14;16)易位，是新型、更积极治疗的候选对象。
