Jhaveri Kenar D, Meena Priti, Bharati Joyita, Bathini Srikanth
Department of Nephrology, The Glomerular Disease Center at Northwell Health, Co-Director, Onconephrology Services Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA.
Department of Nephrology, All India Institute Medical Sciences, Bhubaneswar, India.
Indian J Nephrol. 2025 Jan-Feb;35(1):8-20. doi: 10.25259/ijn_491_23. Epub 2024 Jul 24.
Multiple myeloma (MM) represents a difficult-to-treat plasma cell malignancy and the second most common hematologic malignancy in adults, significantly impacting kidney function. The spectrum of kidney involvement in MM is broad, encompassing electrolyte imbalances, tubular injury, and even rare glomerular diseases. The evolution of MM treatment modalities has led to notable improvements in the long-term survival of patients experiencing kidney-related complications. Over the past decade, groundbreaking therapeutic agents have emerged, including proteasome inhibitors, immunomodulatory drugs, anti-CD38 monoclonal antibodies, selective inhibitors of nuclear export, and antibody-drug conjugates. These novel therapies have revolutionized the landscape of MM management, offering new hope for patients and challenging the traditional treatment paradigms. This comprehensive review explores recent advances in the diagnosis and management of MM, emphasizing the pivotal role of these innovative therapeutic agents in improving patient outcomes. We delve into the intricacies of diagnosing MM, highlighting the significance of early detection and precise diagnostic tools. We elucidate the evolving treatment strategies, emphasizing the mechanisms of action and clinical efficacy of the latest agents. This manuscript provides valuable insights into the ever-evolving field of MM management, shedding light on the remarkable progress achieved in enhancing the prognosis and quality of life of MM patients.
多发性骨髓瘤(MM)是一种难以治疗的浆细胞恶性肿瘤,是成人中第二常见的血液系统恶性肿瘤,对肾功能有显著影响。MM累及肾脏的范围很广,包括电解质失衡、肾小管损伤,甚至罕见的肾小球疾病。MM治疗方式的演变已使出现肾脏相关并发症的患者的长期生存率有了显著提高。在过去十年中,出现了一些突破性的治疗药物,包括蛋白酶体抑制剂、免疫调节药物、抗CD38单克隆抗体、核输出选择性抑制剂和抗体药物偶联物。这些新型疗法彻底改变了MM的治疗格局,为患者带来了新希望,并挑战了传统治疗模式。这篇综述探讨了MM诊断和治疗的最新进展,强调了这些创新治疗药物在改善患者预后方面的关键作用。我们深入研究了MM诊断的复杂性,强调早期检测和精确诊断工具的重要性。我们阐明了不断演变的治疗策略,强调了最新药物的作用机制和临床疗效。这篇文章为MM治疗这一不断发展的领域提供了有价值的见解,揭示了在改善MM患者预后和生活质量方面取得的显著进展。