冒烟型多发性骨髓瘤：患病率及指导治疗决策的当前证据
Smoldering multiple myeloma: prevalence and current evidence guiding treatment decisions.
作者信息
Blum Agnieszka, Bazou Despina, O'Gorman Peter
机构信息
Department of Hematology, Mater Misericordiae University Hospital, Dublin, UK,
出版信息
Blood Lymphat Cancer. 2018 Apr 20;8:21-31. doi: 10.2147/BLCTT.S136447. eCollection 2018.
Abstract
Smoldering multiple myeloma (SMM) is an asymptomatic plasma cell proliferative disorder associated with risk of progression to symptomatic multiple myeloma (MM) or amyloidosis. In comparison to monoclonal gammopathy of undetermined significance (MGUS), SMM has a much higher risk of progression to MM. Thanks to advances in our understanding of the risk factors, the subset of patients with ultra-high risk of progression to MM (80%-90% at 2 years) has been identified. The revision of the diagnostic criteria resulted in changes in the management of this cohort of patients. In contrast to the management guidelines for MGUS patients, SMM patients need to be studied more intensively in order to identify biomarkers necessary for accurate risk stratification. In this review, we focus on the risk of progression from SMM to MM, as well as the influence of early treatment on overall survival, time to progression and quality of life.
摘要
冒烟型多发性骨髓瘤（SMM）是一种无症状的浆细胞增殖性疾病，与进展为有症状的多发性骨髓瘤（MM）或淀粉样变性的风险相关。与意义未明的单克隆丙种球蛋白病（MGUS）相比，SMM进展为MM的风险要高得多。由于我们对风险因素的认识取得了进展，已确定了进展为MM的超高风险患者亚组（2年内进展风险为80%-90%）。诊断标准的修订导致了这一患者群体管理方式的改变。与MGUS患者的管理指南不同，SMM患者需要更深入地研究，以确定准确风险分层所需的生物标志物。在本综述中，我们重点关注SMM进展为MM的风险，以及早期治疗对总生存期、进展时间和生活质量的影响。
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