Progress in the treatment of multiple myeloma can be considered from several points of view: (1) advent of new therapeutic agents and regimens; (2) the differentiation from variant forms; and (3) the prevention or early treatment of myeloma-associated complications. The author have discussed the following problems connected with the treatment of myeloma patients st 4 to 1988, including (1) ten-year survival in multiple myeloma; (2) complete remission in multiple myeloma; (3) complete remission in primary plasma cell leukemia; (4) systemic amyloidosis in multiple myeloma as the presenting symptom; (5) treatments for patients resistant to standard therapies; (6) treatments and courses of patients with IgD myeloma; (7) multiple myeloma in the aged; (8) treatments for patients with primary extramedullary plasmacytoma; (9) long-term observation of a patient with smoldering multiple myeloma; (10) the outcome of idiopathic Bence Jones proteinuria and (11) supportive therapies for multiple myeloma. Since the introduction of melphalan and cyclophosphamide more than two decades ago, progress in the treatment of multiple myeloma has been slow. To overstep the limits in the current chemotherapy, therapeutic strategies for individual cases should be exploited by understanding their biological properties.
(1)新治疗药物和方案的出现;(2)与变异形式的鉴别;(3)骨髓瘤相关并发症的预防或早期治疗。作者探讨了与1988年第4期骨髓瘤患者治疗相关的以下问题,包括:(1)多发性骨髓瘤的十年生存率;(2)多发性骨髓瘤的完全缓解;(3)原发性浆细胞白血病的完全缓解;(4)以系统性淀粉样变性为首发症状的多发性骨髓瘤;(5)对标准治疗耐药患者的治疗;(6)IgD骨髓瘤患者的治疗及疗程;(7)老年多发性骨髓瘤;(8)原发性髓外浆细胞瘤患者的治疗;(9)一名冒烟型多发性骨髓瘤患者的长期观察;(10)特发性本-周蛋白尿的转归;以及(11)多发性骨髓瘤的支持治疗。自二十多年前引入美法仑和环磷酰胺以来,多发性骨髓瘤的治疗进展一直缓慢。为突破当前化疗的局限,应通过了解个体病例的生物学特性来制定个体化治疗策略。