Mateos María-Victoria
Hospital Universitario de Salamanca - Hematology, Paseo San Vicente, 58-182 Salamanca, Spain.
Expert Rev Hematol. 2015 Feb;8(1):19-27. doi: 10.1586/17474086.2015.978852. Epub 2014 Nov 3.
Smoldering multiple myeloma is an asymptomatic disorder characterized by the presence of ≥30 g/l serum M-protein and/or ≥10% bone marrow plasma cell infiltration. The risk of progression to active multiple myeloma is not uniform, and several markers are useful for identifying patients at high risk of this. Although the current standard of care is not to treat, a randomized trial in high-risk smoldering multiple myeloma patients comparing those allocated to receive early treatment with lenalidomide plus dexamethasone with those under observation reported a significant benefit with respect to time to progression and overall survival. We conclude that efforts should be made to identify high-risk patients who are candidates for receiving early treatment before they develop myeloma-related symptomatology.
冒烟型多发性骨髓瘤是一种无症状疾病，其特征为血清M蛋白≥30 g/l和/或骨髓浆细胞浸润≥10%。进展为活动性多发性骨髓瘤的风险并不一致，有几种标志物有助于识别高风险患者。尽管目前的治疗标准是不进行治疗，但一项针对高风险冒烟型多发性骨髓瘤患者的随机试验比较了接受来那度胺加地塞米松早期治疗的患者与观察组患者，结果显示在疾病进展时间和总生存期方面有显著益处。我们得出结论，应努力识别在出现骨髓瘤相关症状之前适合接受早期治疗的高风险患者。
