Abduh Maisa Siddiq
Immune Responses in Different Diseases Research Group, Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.
Saudi J Biol Sci. 2024 Feb;31(2):103920. doi: 10.1016/j.sjbs.2023.103920. Epub 2023 Dec 30.
Multiple Myeloma (MM) is a plasma cell cancer with high mortality and morbidity rates. Its incidence rate has increased by 143% since 1975. Adipokines, cytokines, chemokines, and genetic variations influence the development and progression of MM. Chromosomal translocations cause mutations associated with MM. The pathogenesis of MM is complicated by novel issues like miRNAs, RANKL, Wnt/DKK1, Wnt, and OPG. Conventional diagnosis methods include bone marrow biopsy, sPEP or uPEP, sIFE and uIFE, and sFLC assay, along with advanced techniques such as FISH, SNPA, and gene expression technologies. A novel therapeutic strategy has been developed recently. Chemotherapy, hematopoietic stem cell transplantation, and a variety of drug classes in combination are used to treat patients with high-risk diseases. Alkylating agents, PIs, and IMiDs have all been developed as effective treatment options for MM in recent years. This review overviews the current recommendations for managing MGUS, SMM, MM, SP and NSMM and discusses practices in diagnosing and treating MM.
多发性骨髓瘤（MM）是一种死亡率和发病率都很高的浆细胞癌。自1975年以来，其发病率增长了143%。脂肪因子、细胞因子、趋化因子和基因变异会影响MM的发展和进程。染色体易位会导致与MM相关的突变。MM的发病机制因miRNAs、RANKL、Wnt/DKK1、Wnt和OPG等新问题而变得复杂。传统的诊断方法包括骨髓活检、血清蛋白电泳（sPEP）或尿蛋白电泳（uPEP）、血清免疫固定电泳（sIFE）和尿免疫固定电泳（uIFE）以及血清游离轻链分析（sFLC assay），还有荧光原位杂交（FISH）、单核苷酸多态性分析（SNPA）和基因表达技术等先进技术。最近已经开发出一种新的治疗策略。化疗、造血干细胞移植以及多种药物联合使用来治疗高危疾病患者。近年来，烷化剂、蛋白酶体抑制剂（PIs）和免疫调节药物（IMiDs）都已被开发成为治疗MM的有效选择。本综述概述了目前管理意义未明的单克隆丙种球蛋白病（MGUS）、冒烟型骨髓瘤（SMM）、MM、冒烟型浆细胞白血病（SP）和非冒烟型骨髓瘤（NSMM）的建议，并讨论了MM的诊断和治疗实践。
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