Zhou J Q, Hao M, An G
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China Tianjin Institutes of Health Science, Tianjin 301600, China.
Zhonghua Xue Ye Xue Za Zhi. 2024 Dec 14;45(12):1148-1152. doi: 10.3760/cma.j.cn121090-20240416-00144.
Smoldering multiple myeloma (SMM) patients are a heterogeneous group with variable prognosis. A subset of SMM patients have a higher risk of progressing to multiple myeloma (MM) within 2 years. The definition of high-risk patients is not consistent among different risk models, and the combination of various biomarkers and new technologies improves the predictive performance of risk models. In clinical research, different risk models are often combined and applied. New drugs for treating MM are gradually being applied in the treatment of high-risk SMM. Single or dual drug therapy prolongs the progression free survival of patients, but most studies have not yet shown an overall survival benefit for patients. Multi drug combination and intensive treatment can achieve deep relief in high-risk SMM, but most of the studies are single arm studies, which are not yet sufficient to prove that multi drug treatment is more effective than lower intensity treatment. Further exploration of treatment plans for high-risk SMM patients is still needed. This article reviews the progress in risk stratification and treatment of high-risk SMM.
冒烟型多发性骨髓瘤（SMM）患者是一个预后各异的异质性群体。一部分SMM患者在2年内进展为多发性骨髓瘤（MM）的风险较高。不同风险模型对高危患者的定义并不一致，多种生物标志物与新技术的联合应用提高了风险模型的预测性能。在临床研究中，不同的风险模型常被联合应用。治疗MM的新药正逐渐应用于高危SMM的治疗。单药或双药治疗可延长患者的无进展生存期，但大多数研究尚未显示对患者总生存期有获益。多药联合及强化治疗可使高危SMM达到深度缓解，但大多数研究为单臂研究，尚不足以证明多药治疗比低强度治疗更有效。仍需进一步探索高危SMM患者的治疗方案。本文综述了高危SMM风险分层及治疗的进展。
