Department of Experimental Hematology, Jessa Hospital, Hasselt, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
Department of Experimental Hematology, Jessa Hospital, Hasselt, Belgium; Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.
Clin Lymphoma Myeloma Leuk. 2018 Apr;18(4):235-248. doi: 10.1016/j.clml.2018.02.011. Epub 2018 Feb 17.
Multiple myeloma (MM), characterized by malignant plasma cells in the bone marrow, is consistently preceded by asymptomatic premalignant stage monoclonal gammopathy of undetermined significance (MGUS). These MGUS patients have an annual risk of 1% to progress to MM. Clinical, imaging, and genomic (genetic and epigenetic) factors were identified, whose presence increased the risk of progression from MGUS to MM. In this systematic review we summarize the currently identified clinical, imaging, and genomic biomarkers suggested to increase the progression risk or shown to be differentially expressed/present between both cohorts of patients. Despite the wide range of proposed markers, there are still no reliable biomarkers to individually predict which MGUS patient will progress to MM and which will not. Research on biomarkers in the progression from MGUS to MM will give more insight in the unknown pathogenesis of this hematological malignancy. This would improve research by elucidating new pathways and potential therapeutic targets as well as clinical management by closer follow-up and earlier treatment of high-risk MGUS patients.
多发性骨髓瘤（MM）的特征是骨髓中存在恶性浆细胞，其始终以前无症状的恶性前浆细胞单克隆丙种球蛋白血症（MGUS）为先导。这些 MGUS 患者每年有 1%的风险进展为 MM。已确定了临床、影像和基因组（遗传和表观遗传）因素，其存在增加了从 MGUS 进展为 MM 的风险。在这项系统评价中，我们总结了目前已确定的临床、影像和基因组生物标志物，这些标志物被认为可增加进展风险，或在这两个患者队列之间表现出不同的表达/存在。尽管提出了广泛的标记物，但仍然没有可靠的生物标志物可以单独预测哪些 MGUS 患者会进展为 MM，哪些不会。对从 MGUS 进展为 MM 的生物标志物的研究将更深入地了解这种血液恶性肿瘤的未知发病机制。这将通过阐明新的途径和潜在的治疗靶点以及通过密切随访和早期治疗高危 MGUS 患者来改善临床管理，从而改善研究。
