迈向多发性骨髓瘤治愈的步骤？
Steps towards a Multiple Myeloma Cure?
作者信息
Gozzetti Alessandro, Bocchia Monica
机构信息
Division of Hematology, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
出版信息
J Pers Med. 2022 Sep 3;12(9):1451. doi: 10.3390/jpm12091451.
Abstract
Multiple myeloma survival has increased in last 20 years because of new treatments, better clinical management due to novel diagnostic tools such as imaging, and better understanding of the disease, biologically and genetically. Novel drugs have been introduced that act with different therapeutic mechanisms, but so have novel therapeutic strategies such as consolidation and maintenance after autologous stem cell transplant. Imaging (such as PET-CT and MRI) has been applied at diagnosis and after therapy for minimal residual disease monitoring. Multiparametric flow and molecular NGS may detect, with high-sensitivity, residual monoclonal plasma cells in the bone marrow. With this novel therapeutic and biological approach, a considerable fraction of multiple myeloma patients can achieve durable remission or even MGUS-like regression, which can ultimately lead to disease disappearance. The big dogma, "Myeloma is an incurable disease", is hopefully fading.
摘要
在过去20年中，由于新的治疗方法、借助影像学等新型诊断工具实现的更好的临床管理以及对该疾病在生物学和遗传学方面的更深入了解，多发性骨髓瘤患者的生存期有所延长。已引入了具有不同治疗机制的新型药物，同时也出现了如自体干细胞移植后的巩固和维持等新型治疗策略。影像学检查（如PET-CT和MRI）已应用于诊断以及治疗后微小残留病的监测。多参数流式细胞术和分子二代测序（NGS）能够高灵敏度地检测骨髓中残留的单克隆浆细胞。通过这种新型的治疗和生物学方法，相当一部分多发性骨髓瘤患者能够实现持久缓解，甚至达到类似意义未明的单克隆丙种球蛋白血症（MGUS）的病情逆转，并最终实现疾病消失。“骨髓瘤是一种无法治愈的疾病”这一传统观念有望逐渐淡化。
相似文献
1
Steps towards a Multiple Myeloma Cure?迈向多发性骨髓瘤治愈的步骤？
J Pers Med. 2022 Sep 3;12(9):1451. doi: 10.3390/jpm12091451.
2
Is it possible to cure myeloma without allogeneic transplantation?不进行异基因移植能治愈骨髓瘤吗？
Transfus Apher Sci. 2016 Feb;54(1):63-70. doi: 10.1016/j.transci.2016.01.015. Epub 2016 Jan 21.
3
¹⁸F-FDG PET/CT: a review of diagnostic and prognostic features in multiple myeloma and related disorders.¹⁸F-FDG PET/CT：多发性骨髓瘤及相关疾病的诊断和预后特征综述
Clin Exp Med. 2015 Feb;15(1):1-18. doi: 10.1007/s10238-014-0308-3. Epub 2014 Sep 14.
4
Moving Beyond Autologous Transplantation in Multiple Myeloma: Consolidation, Maintenance, Allogeneic Transplant, and Immune Therapy.多发性骨髓瘤自体移植之外的治疗进展：巩固治疗、维持治疗、异基因移植及免疫治疗
Am Soc Clin Oncol Educ Book. 2016;35:210-21. doi: 10.1200/EDBK_159016.
5
Novel therapeutic targets in multiple myeloma.多发性骨髓瘤的新型治疗靶点
Eur J Haematol. 2000 Jun;64(6):359-67. doi: 10.1034/j.1600-0609.2000.9r233.x.
6
Minimal Residual Disease in Multiple Myeloma: State of the Art and Applications in Clinical Practice.多发性骨髓瘤中的微小残留病：临床实践中的最新技术与应用
J Pers Med. 2020 Sep 10;10(3):120. doi: 10.3390/jpm10030120.
7
Moving Toward a Cure for Myeloma.迈向多发性骨髓瘤治愈之路。
Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-12. doi: 10.1200/EDBK_349603.
8
Longitudinal minimal residual disease assessment in multiple myeloma patients in complete remission - results from the NMSG flow-MRD substudy within the EMN02/HO95 MM trial.多发性骨髓瘤患者完全缓解后的纵向微小残留病灶评估——来自 EMN02/HO95 MM 试验中 NMSG 流式微小残留病灶子研究的结果。
BMC Cancer. 2022 Feb 5;22(1):147. doi: 10.1186/s12885-022-09184-1.
9
Multiple Myeloma: New Insights and Therapeutic Approaches.多发性骨髓瘤：新见解与治疗方法
Hematology Am Soc Hematol Educ Program. 2000:147-165. doi: 10.1182/asheducation-2000.1.147.
10
Value of whole body MRI and dynamic contrast enhanced MRI in the diagnosis, follow-up and evaluation of disease activity and extent in multiple myeloma.全身 MRI 和动态对比增强 MRI 在多发性骨髓瘤的诊断、随访及疾病活动度和范围评估中的价值。
Eur J Radiol. 2013 Sep;82(9):1444-52. doi: 10.1016/j.ejrad.2013.04.012. Epub 2013 May 28.
引用本文的文献
1
Minimal Residual Disease Significance in Multiple Myeloma Patients Treated with Anti-CD38 Monoclonal Antibodies.抗CD38单克隆抗体治疗的多发性骨髓瘤患者中微小残留病的意义
Pharmaceuticals (Basel). 2025 Jan 25;18(2):159. doi: 10.3390/ph18020159.
2
Impact of lenalidomide-bortezomib-dexamethasone induction on patients with newly diagnosed multiple myeloma and renal impairment: Results from the Connect® MM Registry.硼替佐米-来那度胺-地塞米松诱导治疗对新诊断多发性骨髓瘤伴肾功能损害患者的影响：来自 Connect® MM 登记研究的结果。
Blood Cancer J. 2024 Nov 11;14(1):198. doi: 10.1038/s41408-024-01177-6.
3
A scoping review of pharmacists' clinical activities and impact on the care of patients with multiple myeloma.一项关于药师临床活动及其对多发性骨髓瘤患者护理影响的范围综述。
Int J Clin Pharm. 2024 Dec;46(6):1281-1293. doi: 10.1007/s11096-024-01787-x. Epub 2024 Aug 7.
4
Does the Simultaneous Introduction of Several Pharmaceuticals in the Post-Lenalidomide Era Translate to Better Outcomes in Relapse Refractory Multiple Myeloma? Findings from the Real-World Innovation in Multiple Myeloma (REAL IMM) Study.在来那度胺时代之后同时引入几种药物是否能转化为复发难治性多发性骨髓瘤更好的治疗结果？多发性骨髓瘤真实世界创新研究（REAL IMM）的结果。
Cancers (Basel). 2023 Dec 14;15(24):5846. doi: 10.3390/cancers15245846.
5
Characteristics and Risk Factors of Ultra-High-Risk Patients with Newly Diagnosed Multiple Myeloma.新诊断多发性骨髓瘤超高危患者的特征及危险因素
J Pers Med. 2023 Apr 14;13(4):666. doi: 10.3390/jpm13040666.
6
"Friends and foes" of multiple myeloma measurable/minimal residual disease evaluation by next generation flow.下一代流式细胞术评估多发性骨髓瘤可测量/微小残留病的“朋友与敌人”
Front Oncol. 2022 Nov 28;12:1057713. doi: 10.3389/fonc.2022.1057713. eCollection 2022.
本文引用的文献
1
Central Nervous System Myeloma and Unusual Extramedullary Localizations: Real Life Practical Guidance.中枢神经系统骨髓瘤及不常见的髓外定位：现实生活中的实用指南
Front Oncol. 2022 Jul 7;12:934240. doi: 10.3389/fonc.2022.934240. eCollection 2022.
2
Circulating Tumor Cells for the Staging of Patients With Newly Diagnosed Transplant-Eligible Multiple Myeloma.循环肿瘤细胞在新诊断的适合移植的多发性骨髓瘤患者分期中的应用。
J Clin Oncol. 2022 Sep 20;40(27):3151-3161. doi: 10.1200/JCO.21.01365. Epub 2022 Jun 6.
3
Monoclonal gammopathy of renal significance (MGRS): Real-world data on outcomes and prognostic factors.肾相关单克隆丙种球蛋白病（MGRS）：真实世界数据下的结局和预后因素。
Am J Hematol. 2022 Jul;97(7):877-884. doi: 10.1002/ajh.26566. Epub 2022 Apr 20.
4
Consensus guidelines and recommendations for infection prevention in multiple myeloma: a report from the International Myeloma Working Group.共识指南和建议，用于多发性骨髓瘤的感染预防：国际骨髓瘤工作组的报告。
Lancet Haematol. 2022 Feb;9(2):e143-e161. doi: 10.1016/S2352-3026(21)00283-0.
5
Ciltacabtagene autoleucel, a B-cell maturation antigen-directed chimeric antigen receptor T-cell therapy in patients with relapsed or refractory multiple myeloma (CARTITUDE-1): a phase 1b/2 open-label study.西达基奥仑赛，一种针对 B 细胞成熟抗原的嵌合抗原受体 T 细胞疗法，用于治疗复发或难治性多发性骨髓瘤患者（CARTITUDE-1）：一项 1b/2 期开放标签研究。
Lancet. 2021 Jul 24;398(10297):314-324. doi: 10.1016/S0140-6736(21)00933-8. Epub 2021 Jun 24.
6
Idecabtagene Vicleucel in Relapsed and Refractory Multiple Myeloma.伊达比星脂质体注射用多柔比星治疗复发/难治性多发性骨髓瘤
N Engl J Med. 2021 Feb 25;384(8):705-716. doi: 10.1056/NEJMoa2024850.
7
Long-Term Safety of Rapid Daratumumab Infusions in Multiple Myeloma Patients.达雷妥尤单抗快速输注在多发性骨髓瘤患者中的长期安全性
Front Oncol. 2020 Dec 21;10:570187. doi: 10.3389/fonc.2020.570187. eCollection 2020.
8
Standardization of F-FDG-PET/CT According to Deauville Criteria for Metabolic Complete Response Definition in Newly Diagnosed Multiple Myeloma.根据 Deauville 标准对新诊断多发性骨髓瘤代谢完全缓解定义的 F-FDG-PET/CT 标准化。
J Clin Oncol. 2021 Jan 10;39(2):116-125. doi: 10.1200/JCO.20.00386. Epub 2020 Nov 5.
9
Minimal Residual Disease in Multiple Myeloma: State of the Art and Applications in Clinical Practice.多发性骨髓瘤中的微小残留病：临床实践中的最新技术与应用
J Pers Med. 2020 Sep 10;10(3):120. doi: 10.3390/jpm10030120.
10
Functional Imaging for Therapeutic Assessment and Minimal Residual Disease Detection in Multiple Myeloma.多发性骨髓瘤的治疗评估和微小残留病灶检测的功能成像。
Int J Mol Sci. 2020 Jul 29;21(15):5406. doi: 10.3390/ijms21155406.
Zotero 插件