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如何识别和治疗高危冒烟型多发性骨髓瘤。

How to Identify and Manage High-Risk Smoldering Multiple Myeloma.

机构信息

Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, 1 Gustave L. Levy Place, Box 1079, New York, NY, 10029, USA.

出版信息

Curr Oncol Rep. 2024 Nov;26(11):1398-1409. doi: 10.1007/s11912-024-01596-5. Epub 2024 Aug 23.

Abstract

PURPOSE OF REVIEW

It elucidates advancements in identifying and managing high-risk smoldering multiple myeloma (SMM), moving from observation strategies to intervention approaches. It highlights the significance of differentiating high-risk SMM from its less aggressive counterparts to prevent progression to multiple myeloma (MM).

RECENT FINDINGS

Recent developments have improved SMM risk-stratification, integrating clinical, molecular and biological markers to identify high-risk individuals accurately. The advent of dynamic risk models that incorporate disease evolution and the application of novel diagnostic technologies are enhancing the understanding of SMM. Clinical trials exploring low to high intensity interventions, have shown promise in delaying MM onset and improving patient prognosis. There is a significant change in high-risk SMM management, leaning towards early intervention and precision medicine. The focus now is on refining these approaches, exploring new treatments, and proving the sustained benefits of early interventions to ultimately improve SMM patient care and outcomes.

摘要

目的综述

本文阐明了高危冒烟型多发性骨髓瘤 (SMM) 的识别和管理方面的进展,从观察策略转变为干预方法。强调了区分高危 SMM 与侵袭性较低的 SMM 的重要性,以防止进展为多发性骨髓瘤 (MM)。

最近的发现

最近的发展提高了 SMM 的风险分层,整合了临床、分子和生物学标志物,以准确识别高危人群。动态风险模型的出现,结合了疾病的演变,并应用了新的诊断技术,提高了对 SMM 的认识。探索低至高强度干预的临床试验,在延迟 MM 发病和改善患者预后方面显示出前景。高危 SMM 管理发生了重大变化,倾向于早期干预和精准医学。现在的重点是完善这些方法,探索新的治疗方法,并证明早期干预的持续益处,最终改善 SMM 患者的护理和结局。

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