Mouhieddine Tarek H, Ghobrial Irene M, Nadeem Omar
Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
Center for Early Detection and Interception of Blood Cancers, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA.
Best Pract Res Clin Haematol. 2025 Sep;38(3):101641. doi: 10.1016/j.beha.2025.101641. Epub 2025 Jul 9.
Precursor plasma cell disorders include monoclonal gammopathy of undermined significance (MGUS) and smoldering multiple myeloma (SMM). These conditions carry a variable risk of progression to symptomatic myeloma and there are ongoing efforts to improve risk stratification to identify patients that are at highest risk of progression. Advanced imaging plays a crucial role in diagnosis and monitoring, and more sensitive tools to measure serum monoclonal proteins and circulating tumor cells are being developed. The data for early intervention in SMM continues to evolve, with several phase III studies demonstrating benefit compared to observation. There are ongoing studies evaluating the role of combination and T cell immunotherapies in patients with precursor plasma cell disorders. This review will highlight the current state of the art tools in diagnosis, risk stratification, and data for early interception in patients with precursor plasma cell dyscrasias.
前驱浆细胞疾病包括意义未明的单克隆丙种球蛋白病（MGUS）和冒烟型多发性骨髓瘤（SMM）。这些疾病进展为有症状骨髓瘤的风险各异，目前正在努力改进风险分层，以识别进展风险最高的患者。先进的影像学在诊断和监测中起着关键作用，并且正在开发更敏感的工具来测量血清单克隆蛋白和循环肿瘤细胞。SMM早期干预的数据不断发展，多项III期研究表明与观察相比有获益。目前正在进行研究评估联合治疗和T细胞免疫疗法在前驱浆细胞疾病患者中的作用。本综述将重点介绍前驱浆细胞发育异常患者在诊断、风险分层和早期拦截数据方面的当前先进工具。
