Tan Daryl, Lee Jae Hoon, Chen Wenming, Shimizu Kazuyuki, Hou Jian, Suzuki Kenshi, Nawarawong Weerasak, Huang Shang-Yi, Sang Chim Chor, Kim Kihyun, Kumar Lalit, Malhotra Pankaj, Chng Wee Joo, Durie Brian
a Raffles Cancer Center , Raffles Hospital , Singapore.
b Department of Hematology , Singapore General Hospital , Singapore.
Leuk Lymphoma. 2018 Oct;59(10):2305-2317. doi: 10.1080/10428194.2018.1427858. Epub 2018 Feb 2.
Predicated on our improved understanding of the disease biology, we have seen remarkable advances in the management of multiple myeloma over the past few years. Recently approved drugs have radically transformed the treatment paradigm and improved survivals of myeloma patients. The progress has necessitated revision of the diagnostic criteria, risk-stratification and response definition. The huge disparities in economy, healthcare infrastructure and access to novel drugs among different Asian countries will hinder the delivery of optimum myeloma care to patients managed in resource-constrained environments. In the light of the tremendous recent changes and evolution in myeloma management, it is timely that the resource-stratified guidelines from the Asian Myeloma Network be revised to provide updated recommendations for Asia physicians practicing under various healthcare reimbursement systems. This review will highlight the most recent advances and our recommendations on how they could be integrated in both resource-abundant and resource-constrained facilities.
基于我们对疾病生物学的深入理解,在过去几年中,我们在多发性骨髓瘤的管理方面取得了显著进展。最近获批的药物彻底改变了治疗模式,提高了骨髓瘤患者的生存率。这一进展使得有必要修订诊断标准、风险分层和缓解定义。不同亚洲国家在经济、医疗基础设施以及获得新药方面存在巨大差异,这将阻碍在资源有限环境中接受治疗的患者获得最佳的骨髓瘤治疗。鉴于骨髓瘤管理领域最近发生的巨大变化和演变,亚洲骨髓瘤网络根据资源分层制定的指南适时修订,为在各种医疗报销系统下执业的亚洲医生提供最新建议,恰逢其时。本综述将重点介绍最新进展以及我们关于如何在资源丰富和资源有限的医疗机构中整合这些进展的建议。