Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA; and.
Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
Blood. 2015 May 14;125(20):3085-99. doi: 10.1182/blood-2014-11-568923. Epub 2015 Apr 2.
Over the last few decades, significant improvement in outcomes has been observed for myeloma patients, mainly as a result of the use of currently available approved antimyeloma agents, along with combining autologous stem cell transplantation in the treatment of myeloma. With more targeted agents in development, the treatment of a myeloma patient at relapse has become complicated and, as a consequence, results in vast heterogeneity in treatment patterns. Although a consensus on the timing of initiation of treatment, the choice of agents to be used, and the role of transplant is less clear, we describe an evidence-based approach and the factors to consider upon relapse. We describe additional newer agents and targets that are under development, with the goal of achievement of durable remissions for myeloma patients.
在过去的几十年中，骨髓瘤患者的治疗效果有了显著的改善，这主要是由于目前可用的批准的抗骨髓瘤药物的使用，以及在骨髓瘤的治疗中结合自体干细胞移植。随着更多靶向药物的开发，复发骨髓瘤患者的治疗变得复杂，因此导致治疗模式存在巨大的异质性。尽管在治疗开始的时机、选择使用的药物以及移植的作用方面存在共识，但不太明确，我们描述了一种基于证据的方法以及在复发时需要考虑的因素。我们描述了正在开发的其他新的药物和靶点，以期为骨髓瘤患者实现持久缓解。
