Varterasian M L
Division of Hematology and Oncology, Wayne State University, Harper Hospital, Detroit, Michigan, USA.
Oncology (Williston Park). 1995 May;9(5):417-24; discussion 429-30.
Recent advances in our understanding of the cellular and molecular derangements involved in multiple myeloma are beginning to be translated into novel therapeutic approaches. Growth factors, specifically interleukin-6, appear to be critical for disease progression, and interruption of autocrine and paracrine loops has been achieved, with resultant inhibition of myeloma cell growth. Oncogenes, tumor-suppressor genes, and cell-survival genes have all been found to be dysregulated in some myeloma patients. The implications of acquisition of the multidrug resistance phenotype are just beginning to be understood. High-dose therapeutic regimens with bone marrow or peripheral stem-cell rescue are being studied in an attempt to produce a cure. Autologous marrow and peripheral blood stem-cell transplantation are better suited to the older myeloma patient population than is allogeneic marrow transplantation, and have also yielded promising results.
我们对多发性骨髓瘤所涉及的细胞和分子紊乱的理解取得了最新进展，这些进展正开始转化为新的治疗方法。生长因子，特别是白细胞介素-6，似乎对疾病进展至关重要，并且已经实现了自分泌和旁分泌环路的中断，从而抑制了骨髓瘤细胞的生长。在一些骨髓瘤患者中，已发现癌基因、肿瘤抑制基因和细胞存活基因均存在失调。对多药耐药表型获得的影响才刚刚开始被理解。正在研究采用骨髓或外周干细胞救援的大剂量治疗方案，以期实现治愈。自体骨髓和外周血干细胞移植比异基因骨髓移植更适合老年骨髓瘤患者群体，并且也已产生了有希望的结果。
