Attal Michel, Moreau Philippe, Avet-Loiseau Herve, Harousseau Jean-Luc
Hopital Purpan, Place du Dr. Baylac, 31059 Toulouse, France.
Hematology Am Soc Hematol Educ Program. 2007:311-6. doi: 10.1182/asheducation-2007.1.311.
Multiple myeloma (MM) is one of the key hematologic malignancies in which the impact of dose intensity has been demonstrated. Consequently, in 2005, MM was the most common disease for which autologous stem cell transplantation (ASCT) was indicated both in Europe and in the U.S. However, ASCT is not curative, and most patients relapse within a median of 3 years. Novel agents such as thalidomide (Thalidomid), bortezomib (Velcade), or lenalidomide (Revlimid) have been introduced to improve high-dose therapy, and promising results have been reported. Conversely, results from myeloablative allogeneic stem cell transplantation remain disappointing due to high transplantation-related mortality, justifying the exploration of strategies such as reduced-intensity conditioning, which have been shown to be feasible but for which proof of efficacy requires continued study.
多发性骨髓瘤（MM）是已证实剂量强度具有影响的关键血液系统恶性肿瘤之一。因此，在2005年，MM是欧洲和美国自体干细胞移植（ASCT）应用最为普遍的疾病。然而，ASCT并非治愈性疗法，大多数患者在中位3年内复发。已引入沙利度胺（反应停）、硼替佐米（万珂）或来那度胺（瑞复美）等新型药物以改善大剂量疗法，并已有报道取得了有前景的结果。相反，清髓性异基因干细胞移植的结果因高移植相关死亡率而仍然令人失望，这使得诸如减低预处理强度等策略的探索具有合理性，这些策略已被证明是可行的，但疗效证据仍需持续研究。
