Chudasama Rani, Barth Peter
Alpert Medical School of Brown University, Division of Hematology Oncology, Rhode Island Hospital/The Miriam Hospital, Providence, RI.
Assistant Professor of Medicine, Alpert Medical School of Brown University, Division of Hematology-Oncology, Rhode Island Hospital/The Miriam Hospital, Providence, RI.
R I Med J (2013). 2020 Apr 1;103(3):46-47.
With advances in the treatment of plasma cell disorders, there have also been improvements in the risk stratification of these diseases. There are currently no screening recommendations for monoclonal gammopathy of unknown significance (MGUS); however, new studies are analyzing the role of screening for patients age 40-75 who are African American or have a family history of multiple myeloma (MM). Patients with smoldering multiple myeloma (SMM) have an increased risk of progression to MM when compared to MGUS. Data have shown that evaluation of bone marrow biopsy, full body MRI and free light chain ratios can identify high-risk SMM patients. Current investigation into early initiation of treatment for patients with SMM who do not meet criteria for MM showed improvement in time to progression. By continuing to evaluate clinical markers of disease burden, physicians can risk stratify patients to identify those at highest risk for progression to MM.
随着浆细胞疾病治疗方法的进步，这些疾病的风险分层也有所改善。目前对于意义未明的单克隆丙种球蛋白病（MGUS）尚无筛查建议；然而，新的研究正在分析对年龄在40 - 75岁的非裔美国人或有多发性骨髓瘤（MM）家族史的患者进行筛查的作用。与MGUS相比，冒烟型多发性骨髓瘤（SMM）患者进展为MM的风险增加。数据表明，评估骨髓活检、全身MRI和游离轻链比值可以识别高危SMM患者。目前针对不符合MM标准的SMM患者早期开始治疗的研究显示，疾病进展时间有所改善。通过持续评估疾病负担的临床指标，医生可以对患者进行风险分层，以识别那些进展为MM风险最高的患者。
