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年轻骨髓瘤患者:临床表现和结局的系统评价。

Young Myeloma Patients: A Systematic Review of Manifestations and Outcomes.

机构信息

Institut Universitaire d'Hémato-Oncologie et de Thérapie Cellulaire, Hôpital Maisonneuve-Rosemont, 5415 de l'Assomption, Montreal, QC H1T 2M4, Canada.

Departement of Medicine, Université de Montréal, 2900 Édouard-Montpetit, Montreal, QC H3T 1J4, Canada.

出版信息

Curr Oncol. 2023 May 23;30(6):5214-5226. doi: 10.3390/curroncol30060396.

Abstract

Multiple myeloma usually affects older adults. However, younger patients constitute a significant subset as approximately 10% of cases occur in subjects younger than 50 years old. Young patients, who are underrepresented in the literature, are diagnosed during their most productive years of life, urging the need for tailored treatment approaches. This literature review aims to report recent studies specifically addressing young patients with a focus on characteristics at diagnosis, cytogenetics, treatments, and outcomes. We searched PubMed for studies involving young patients with multiple myeloma ≤50 years old. The time span of our literature review search was from 1 January 2010 to 31 December 2022. Overall, 16 retrospective studies were analyzed for this review. Young patients with multiple myeloma tend to have less advanced disease, more frequent light chain subtypes, and survive longer compared to their older counterparts. However, available studies included a limited number of patients; the newest revised international staging system was not used to stratify patients, cytogenetics varied from one cohort to another, and most patients did not receive contemporary triplet/quadruplet treatments. This review emphasizes the need to perform contemporary, large-scale retrospective studies to improve knowledge regarding the presentation and outcomes of young myeloma patients in the era of modern treatments.

摘要

多发性骨髓瘤通常影响老年人。然而,年轻患者构成了一个重要的亚组,约有 10%的病例发生在 50 岁以下的患者中。在文献中代表性不足的年轻患者在其最具生产力的生命阶段被诊断出来,因此需要制定针对他们的治疗方法。本文献综述旨在报告最近专门针对年轻多发性骨髓瘤患者的研究,重点关注诊断时的特征、细胞遗传学、治疗和结果。我们在 PubMed 上搜索了涉及≤50 岁的年轻多发性骨髓瘤患者的研究。我们的文献综述搜索时间跨度为 2010 年 1 月 1 日至 2022 年 12 月 31 日。总体而言,对 16 项回顾性研究进行了分析。与老年患者相比,年轻的多发性骨髓瘤患者往往疾病程度较轻,轻链亚型更常见,生存时间更长。然而,现有研究纳入的患者数量有限,最新修订的国际分期系统未用于分层患者,细胞遗传学在不同队列之间存在差异,且大多数患者未接受当代三联/四联治疗。本综述强调需要进行现代、大规模的回顾性研究,以提高对现代治疗时代年轻骨髓瘤患者临床表现和结局的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f3b/10297423/d2e4642198a8/curroncol-30-00396-g001.jpg

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