Murakami Hirokazu, Handa Hiroshi, Saitoh Takayuki
School of Health Sciences, Faculty of Medicine, Gunma University.
Nihon Rinsho. 2007 Dec;65(12):2167-76.
The prognosis of patients with multiple myeloma has been improved in the last decade due to the induction of autologous stem cell transplantation and novel drugs including thalidomide, lenalidomide, and bortezomib into the treatment. Recently, the UK Myeloma Forum and International Myeloma Foundation have successively proposed myeloma management guidelines. Because many novel drugs are not available in Japanese patients, we can not use the same treatment strategy in U.S.A. and Europe. In this chapter, the diagnosis and management guideline is proposed for Japanese patients with myeloma. For convenience, the recommendations are divided into: 1. Diagnostic criteria 2. Indications for starting therapy 3. Treatment(initial therapy, maintenance therapy, and therapy for refractory/relapsed patients) 4. Response criteria 5. Supportive care and management of specific complications.
在过去十年中,由于自体干细胞移植以及包括沙利度胺、来那度胺和硼替佐米在内的新型药物被引入治疗,多发性骨髓瘤患者的预后得到了改善。最近,英国骨髓瘤论坛和国际骨髓瘤基金会相继提出了骨髓瘤管理指南。由于许多新型药物在日本患者中无法获得,我们在美国和欧洲不能采用相同的治疗策略。在本章中,针对日本骨髓瘤患者提出了诊断和管理指南。为方便起见,建议分为:1. 诊断标准 2. 开始治疗的指征 3. 治疗(初始治疗、维持治疗以及难治性/复发性患者的治疗)4. 缓解标准 5. 支持性护理和特定并发症的管理。