Jasielec Jagoda K, Jakubowiak Andrzej J
Section of Hematology/Oncology, Department of Medicine & Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA.
Int J Hematol Oncol. 2013 Feb;2(1). doi: 10.2217/ijh.13.3.
The treatment of newly diagnosed multiple myeloma has dramatically changed since the emergence of proteasome inhibitors and immunomodulatory drugs. Front-line combination regimens incorporating novel drugs such as thalidomide, bortezomib and lenalidomide, have significantly improved response rates and are the standard of care for induction regimens. Although the timing and role of autologous stem cell transplant are now being questioned, it remains an important part of the treatment paradigm in eligible patients. In addition, the concept of extended sequential therapy has recently emerged, including consolidation and/or maintenance in both the post-transplant setting and in nontransplant candidates. In this article we focus on management strategies in newly diagnosed multiple myeloma, including choice of induction regimens in transplant-eligible and -ineligible patients, as well as the role of autologous stem cell transplant, consolidation therapy and maintenance therapy.
自从蛋白酶体抑制剂和免疫调节药物出现以来，新诊断的多发性骨髓瘤的治疗发生了巨大变化。包含沙利度胺、硼替佐米和来那度胺等新药的一线联合方案显著提高了缓解率，是诱导方案的标准治疗方法。尽管自体干细胞移植的时机和作用目前受到质疑，但它仍是符合条件患者治疗模式的重要组成部分。此外，最近出现了延长序贯治疗的概念，包括在移植后阶段和非移植候选患者中的巩固和/或维持治疗。在本文中，我们重点关注新诊断的多发性骨髓瘤的管理策略，包括适合和不适合移植患者诱导方案的选择，以及自体干细胞移植、巩固治疗和维持治疗的作用。
