Department of Medicine, Division of Hematology Oncology, Blood and Marrow Transplantation, University of Arizona, Tucson, AZ, 85721, United States.
Department of Internal Medicine, McLaren-Flint Medical Center, Flint, MI, 48532, United States.
Crit Rev Oncol Hematol. 2019 May;137:18-26. doi: 10.1016/j.critrevonc.2019.02.011. Epub 2019 Feb 27.
Multiple Myeloma (MM) is primarily a disease of old age with a median age of sixty-nine years at diagnosis. The development of novel therapies for induction and use of autologous stem cell transplantation has resulted in improved clinical outcomes and better quality of life for MM patients. Elderly patients, comprising the majority of MM population, have a higher incidence of age-related comorbidities, frailty and organ dysfunction which complicates the coordination of treatment and limits the selection of therapies. Even in the era of multiple chemotherapeutic options, the clinical heterogeneity of the myeloma patients' demands personalized treatments which often require dose-adjustments or dose delays. The use of reduced-dose regimens and various comorbidity indices has improved clinical outcome and regimen tolerability in MM patients with renal, neurological and bone abnormalities. We focus on advancements in the treatment of multiple myeloma with the goal to guide clinicians towards patient-specific management.
多发性骨髓瘤（MM）主要是一种老年疾病，诊断时的中位年龄为六十九岁。新型诱导治疗和自体干细胞移植的应用，改善了 MM 患者的临床结局和生活质量。老年人构成了 MM 患者的大多数，他们患有与年龄相关的合并症、虚弱和器官功能障碍的发生率更高，这增加了治疗协调的复杂性，并限制了治疗方案的选择。即使在多种化疗选择的时代，骨髓瘤患者的临床表现异质性也要求进行个性化治疗，这往往需要剂量调整或延迟给药。在伴有肾脏、神经和骨骼异常的 MM 患者中，采用低剂量方案和各种合并症指数，提高了临床疗效和方案耐受性。我们专注于多发性骨髓瘤治疗的进展，旨在为临床医生提供针对患者个体的管理建议。
