Fonseca Rafael, Monge Jorge, Dimopoulos Meletios A
Department of Medicine, Mayo Clinic in Arizona, Scottsdale, AZ 85259-5494, USA.
Expert Rev Hematol. 2014 Feb;7(1):21-31. doi: 10.1586/17474086.2014.882224.
Multiple myeloma (MM) is a heterogeneous disease that, over the past 15 years, has seen an increased understanding of its biology and of novel therapeutic options. Distinctive subtypes of the disease have been described, each with different outcomes and clinic-pathological features. Even though a detailed classification of MM into at least seven or eight major subtypes is possible, a more practical clinical approach can classify the disease into high-risk and non-high-risk MM. Such classification has permitted a more personalized approach to the management of the disease. Additionally, risk stratification should be included in outcome discussions with patients, as survival differs significantly by high-risk status. Nowadays, test for risk stratification are widely available and can be routinely used in the clinic. A greater understanding of the genetic abnormalities underlying the biology of MM will allow for the development of novel targeted therapies and better prognostic markers of the disease.
多发性骨髓瘤(MM)是一种异质性疾病,在过去15年里,人们对其生物学特性和新型治疗选择有了更多的了解。该疾病已被描述出不同的亚型,每种亚型都有不同的预后和临床病理特征。尽管有可能将MM详细分类为至少七到八个主要亚型,但更实用的临床方法可将该疾病分为高危和非高危MM。这种分类使得对该疾病的管理能够采取更个性化的方法。此外,在与患者讨论预后时应纳入风险分层,因为高危状态下的生存率有显著差异。如今,风险分层检测广泛可用,可在临床中常规使用。对MM生物学基础的基因异常有更深入的了解将有助于开发新型靶向疗法和更好的疾病预后标志物。