Gertz Morie A, Dingli David
Division of Hematology and.
Division of Hematology and Department of Molecular Medicine, Mayo Clinic, Rochester, MN.
Blood. 2014 Aug 7;124(6):882-90. doi: 10.1182/blood-2014-03-544759. Epub 2014 Jun 27.
An estimated 22 350 patients had multiple myeloma diagnosed in 2013, representing 1.3% of all new cancers; 10 710 deaths are projected, representing 1.8% of cancer deaths. Approximately 0.7% of US men and women will have a myeloma diagnosis in their lifetime, and with advances in therapy, 77 600 US patients are living with myeloma. The 5-year survival rate was 25.6% in 1989 and was 44.9% in 2005. The median age at diagnosis is 69 years, with 62.4% of patients aged 65 or older at diagnosis. Median age at death is 75 years. The rate of new myeloma cases has been rising 0.7% per year during the past decade. The most common indication for autologous stem cell transplantation in the United States is multiple myeloma, and this article is designed to provide the specifics of organizing a transplant program for multiple myeloma. We review the data justifying use of stem cell transplantation as initial management in myeloma patients. We provide selection criteria that minimize the risks of transplantation. Specific guidelines on mobilization and supportive care through the transplant course, as done at Mayo Clinic, are given. A review of the data on tandem vs sequential autologous transplants is provided.
据估计，2013年有22350例患者被诊断为多发性骨髓瘤，占所有新发癌症的1.3%；预计有10710人死亡，占癌症死亡人数的1.8%。美国约0.7%的男性和女性一生中会被诊断出患有骨髓瘤，随着治疗方法的进步，美国有77600名患者患有骨髓瘤。1989年的5年生存率为25.6%，2005年为44.9%。诊断时的中位年龄为69岁，62.4%的患者在诊断时年龄为65岁或以上。死亡时的中位年龄为75岁。在过去十年中，新发骨髓瘤病例的发生率每年上升0.7%。在美国，自体干细胞移植最常见的适应症是多发性骨髓瘤，本文旨在提供组织多发性骨髓瘤移植项目的具体细节。我们回顾了证明干细胞移植可作为骨髓瘤患者初始治疗方法的数据。我们提供了将移植风险降至最低的选择标准。给出了梅奥诊所针对移植过程中的动员和支持治疗的具体指南。还提供了关于串联自体移植与序贯自体移植数据的综述。
