1] Department of Haematology Oncology, National University Cancer Institute, Singapore, National University Health System, Singapore, Singapore [2] Experimental Therapeutics, Cancer Science Institute of Singapore, Singapore, Singapore [3] Department of Medicine, Yoo Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
Leukemia. 2014 Feb;28(2):269-77. doi: 10.1038/leu.2013.247. Epub 2013 Aug 26.
Multiple myeloma is characterized by underlying clinical and biological heterogeneity, which translates to variable response to treatment and outcome. With the recent increase in treatment armamentarium and the projected further increase in approved therapeutic agents in the coming years, the issue of having some mechanism to dissect this heterogeneity and rationally apply treatment is coming to the fore. A number of robustly validated prognostic markers have been identified and the use of these markers in stratifying patients into different risk groups has been proposed. In this consensus statement, the International Myeloma Working Group propose well-defined and easily applicable risk categories based on current available information and suggests the use of this set of prognostic factors as gold standards in all clinical trials and form the basis of subsequent development of more complex prognostic system or better prognostic factors. At the same time, these risk categories serve as a framework to rationalize the use of therapies.
多发性骨髓瘤的特征是潜在的临床和生物学异质性,这导致了对治疗的反应和结果存在差异。随着近年来治疗手段的增加,以及未来几年预计会有更多的治疗药物获得批准,因此需要有一种机制来剖析这种异质性,并合理地应用治疗方法。已经确定了许多经过严格验证的预后标志物,并且已经提出使用这些标志物将患者分层为不同的风险组。在这份共识声明中,国际骨髓瘤工作组根据现有信息提出了明确且易于应用的风险类别,并建议在所有临床试验中使用这组预后因素作为金标准,并作为随后开发更复杂的预后系统或更好的预后因素的基础。同时,这些风险类别也为合理使用治疗方法提供了框架。