Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Best Pract Res Clin Haematol. 2020 Mar;33(1):101152. doi: 10.1016/j.beha.2020.101152. Epub 2020 Jan 25.
Multiple myeloma, a bone marrow cancer, is preceded by precursor stages called monoclonal gammopathy of unknown significance and smoldering multiple myeloma. Over the past few years, highly effective and safe therapies have been made available to treat multiple myeloma. This represents a major breakthrough and has major therapeutic implications. Treatment for multiple myeloma has evolved to include treatment of precursor stages (early treatment) as these therapies are shown to be safe and effective also in smoldering myeloma. Randomized studies have shown that early treatment can delay the onset of multiple myeloma and even improve overall survival compared to observation in smoldering myeloma. The best therapeutic course and selection of patients with smoldering myeloma to treat is still a matter of debate. In this manuscript, we review the definition, management, clinical implications of smoldering myeloma and early detection of myeloma in the current context and with up-to-date data.
多发性骨髓瘤是一种骨髓癌，其前期阶段分别为意义未明的单克隆丙种球蛋白血症和冒烟型多发性骨髓瘤。在过去几年中，已经出现了高效且安全的治疗方法来治疗多发性骨髓瘤。这是一个重大的突破，具有重要的治疗意义。多发性骨髓瘤的治疗已经发展到包括前期阶段的治疗（早期治疗），因为这些疗法在冒烟型骨髓瘤中也显示出安全有效。随机研究表明，与观察冒烟型骨髓瘤相比，早期治疗可以延迟多发性骨髓瘤的发作，甚至改善总体生存率。在冒烟型骨髓瘤患者中选择最佳的治疗方案和患者选择仍然存在争议。在本文中，我们在当前背景下并结合最新数据，回顾了冒烟型骨髓瘤的定义、管理和临床意义以及多发性骨髓瘤的早期检测。
