Ibrahim Ahmad, Chamseddine Nabil, El-Cheikh Jean, Hanna Colette, Moukadem Walid, Nasr Fady, Younis Ahmad, Bazarbachi Ali
Department of Hematology-Oncology, Makassed University Hospital, Beirut, Lebanon.
School of Medicine, National Lebanese University, Hadath, Lebanon.
Clin Hematol Int. 2022 Dec;4(4):127-132. doi: 10.1007/s44228-022-00017-3. Epub 2022 Aug 30.
Multiple myeloma (MM) is a prevalent hematological malignancy. Resource-constrained settings such as the Middle East are particularly burdened by the increasing trends in MM morbidity and mortality in addition to challenges in the management of MM. It thus becomes necessary to identify and address debatable areas of current practice and gaps in the management of MM in the Middle East. With a special focus on the Lebanese situation, the first-line treatment of the very elderly (> 80 years old) is discussed, in addition to the impact of relapse type (biochemical or clinical relapse) on maintenance therapy, the choice of first relapse therapy in relation to maintenance therapy, and the role of MRD in the MM treatment landscape. The need for realistic management guidelines accounting for local resources and expertise, in addition to the reflection of drug accessibility and cost on clinical practice are recognized.
多发性骨髓瘤（MM）是一种常见的血液系统恶性肿瘤。中东等资源受限地区，除了多发性骨髓瘤管理方面的挑战外，MM发病率和死亡率的上升趋势使其负担尤为沉重。因此，有必要识别并解决中东地区当前MM治疗实践中存在争议的领域以及管理方面的差距。特别关注黎巴嫩的情况，除了复发类型（生化或临床复发）对维持治疗的影响、首次复发治疗相对于维持治疗的选择以及微小残留病（MRD）在MM治疗格局中的作用外，还讨论了超高龄（>80岁）患者的一线治疗。认识到需要制定考虑当地资源和专业知识的切实可行的管理指南，以及药物可及性和成本对临床实践的影响。
