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骨髓瘤的支持性护理——当仅治疗克隆细胞不足够时。

Supportive care in myeloma-when treating the clone alone is not enough.

作者信息

Zweegman Sonja, van de Donk Niels W C J

机构信息

Department of Hematology, Amsterdam University Medical Center, Universiteit van Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.

出版信息

Hematology Am Soc Hematol Educ Program. 2024 Dec 6;2024(1):569-581. doi: 10.1182/hematology.2024000579.

Abstract

The overall survival in patients with multiple myeloma has increased over recent decades. This trend is anticipated to further advance with the emergence of T-cell-redirecting therapies, including chimeric antigen receptor T-cell (CAR T) therapy and T-cell-engaging bispecific antibodies. Despite these therapeutic improvements, treatment-related adverse events impede quality of life. This underscores the imperative of optimizing supportive care strategies to maximize treatment outcomes. Such optimization is crucial not only for patient well-being but also for treatment adherence, which may translate into long-term disease control. We here describe a) how to prevent bone disease, b) a risk-adapted thrombosis prophylaxis approach, c) the management of on-target, off-tumor toxicity of G-protein-coupled receptor class C group 5 member D-targeting T-cell-redirecting therapies, and d) infectious prophylaxis, with a focus on infections during T-cell-redirecting therapies.

摘要

在过去几十年中,多发性骨髓瘤患者的总生存率有所提高。随着包括嵌合抗原受体T细胞(CAR T)疗法和双特异性T细胞衔接抗体在内的T细胞重定向疗法的出现,这一趋势预计将进一步发展。尽管有这些治疗上的改进,但治疗相关不良事件仍会影响生活质量。这凸显了优化支持性护理策略以最大化治疗效果的紧迫性。这种优化不仅对患者的健康至关重要,对治疗依从性也很关键,而治疗依从性可能转化为长期疾病控制。我们在此描述:a)如何预防骨病,b)一种根据风险调整的血栓预防方法,c)针对靶向G蛋白偶联受体C类第5组成员D的T细胞重定向疗法的靶点外肿瘤毒性的管理,以及d)感染预防,重点是T细胞重定向疗法期间的感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2598/11665544/4c94d1c5ba56/hem.2024000579_s1.jpg

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