Manier Salomon, de Charette de la Contrie Marie, Hieulle Julia, Daniel Adrien, Facon Thierry
CHU de Lille, hôpital Huriez, université de Lille, service d'hématologie, 59000 Lille, France.
CHU de Lille, hôpital Huriez, université de Lille, service d'hématologie, 59000 Lille, France.
Presse Med. 2019 Jul-Aug;48(7-8 Pt 1):825-831. doi: 10.1016/j.lpm.2019.07.023. Epub 2019 Aug 22.
Diagnosis criteria have been revised in 2014 and allow the treatment of some asymptomatic patients. Since 2015, a new prognostic score includes tumor plasma cells chromosomal abnormalities. It helps in the distinction between "standard risk" and "high risk" myelomas. Scanner, MRI and Pet Scan are the radiological reference exams to evaluate bone involvement. Alkylating agents, immunomodulators, proteasome inhibitors, and monoclonal antibodies became the most important antitumoral treatments. Risk notion will become more and more important for therapeutic choices. These choices will depend on residual disease evaluation. The next decade will be the immunotherapies development decade.
诊断标准已于2014年修订,允许对一些无症状患者进行治疗。自2015年以来,一种新的预后评分纳入了肿瘤浆细胞染色体异常情况。这有助于区分“标准风险”和“高风险”骨髓瘤。扫描仪、磁共振成像(MRI)和正电子发射断层显像(PET)扫描是评估骨骼受累情况的放射学参考检查。烷化剂、免疫调节剂、蛋白酶体抑制剂和单克隆抗体成为最重要的抗肿瘤治疗手段。风险概念对于治疗选择将变得越来越重要。这些选择将取决于残留疾病评估。未来十年将是免疫疗法发展的十年。