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华氏巨球蛋白血症的新型治疗方案。

Novel treatment regimens for Waldenström's macroglobulinemia.

机构信息

University Hospital of Salamanca, Universidad de Salamanca-Consejo Superior de Investigaciones Científicas, Paseo de San Vicente 58-182, Salamanca 37007, Spain.

出版信息

Expert Rev Hematol. 2010 Jun;3(3):339-50. doi: 10.1586/ehm.10.19.

Abstract

Waldenström's macroglobulinemia (WM) is a B-cell lymphoproliferative disorder defined by bone marrow infiltration by lymphoplasmacytic cells as defined by the current classification systems. According to its transition situation between mutated chronic lymphocytic leukemia and multiple myeloma, several new therapeutic alternatives have been proposed for this entity based on the experience with these two well-known conditions together with the highly singular data provided by preclinical models. Thus, in WM two main therapeutic attitudes are possible: the use of conventional therapies based on the administration of single drugs or combinations with alkylating agents, purine analogues and anti-CD20 monoclonal antibodies; or the use of very new combinations that, without rejecting the previously mentioned drugs, include new agents, such as proteasome inhibitors, immunomodulatory agents or even histone deacetylase inhibitors and PI3K/AKT inhibitors, among others. Here we review the most recent results reported for the use of new combinations and new drugs in patients with WM at different stages of the disease.

摘要

华氏巨球蛋白血症(WM)是一种 B 细胞淋巴增生性疾病,其骨髓中淋巴浆细胞浸润符合当前分类系统的定义。根据其在突变性慢性淋巴细胞白血病和多发性骨髓瘤之间的过渡情况,针对这种疾病,除了基于对这两种著名疾病的经验以及临床前模型提供的高度独特数据外,还提出了几种新的治疗选择。因此,WM 有两种主要的治疗态度:使用基于单一药物或联合烷化剂、嘌呤类似物和抗 CD20 单克隆抗体的常规疗法;或使用非常新的联合疗法,在不排斥上述药物的情况下,包括新的药物,如蛋白酶体抑制剂、免疫调节剂,甚至组蛋白去乙酰化酶抑制剂和 PI3K/AKT 抑制剂等。在这里,我们回顾了在疾病的不同阶段使用新的联合疗法和新药治疗 WM 患者的最新结果。

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