Hussein M
Department of Hematology and Oncology, Cleveland Clinic Foundation, OH 44195.
Cleve Clin J Med. 1994 Jul-Aug;61(4):285-98. doi: 10.3949/ccjm.61.4.285.
Multiple myeloma, a lethal disease resulting from proliferation of immunoglobulin-secreting cells, accounts for approximately 1% of malignant neoplasms in the United States and affects blacks twice as often as whites.
To review the historic, epidemiologic, diagnostic, and therapeutic features of multiple myeloma.
Multiple myeloma is often diagnosed when a monoclonal protein is found in the serum or urine or both. No single test differentiates benign from malignant plasma cell proliferation. The clinical features of multiple myeloma develop from tissue damage secondary to the monoclonal gammopathy, plasma cells, and cytokines excreted by the cells. Increased vulnerability to infection is due to depressed normal immunoglobulins. The melphalan-and-prednisone regimen improves median survival from 7 months to 3 years in the 50% to 60% of patients who respond. Cure is exceedingly rare. Refractory and resistant multiple myeloma patients should be treated on investigational protocols.
There has been substantial advancement in our understanding of the biology of multiple myeloma and related plasma cell neoplasms over the past two decades. We can reasonably hope that improvements in treatment will ensue.
多发性骨髓瘤是一种由分泌免疫球蛋白的细胞增殖引起的致命疾病，在美国约占恶性肿瘤的1%，黑人的发病率是白人的两倍。
综述多发性骨髓瘤的历史、流行病学、诊断和治疗特点。
当在血清或尿液或两者中发现单克隆蛋白时，通常可诊断出多发性骨髓瘤。没有单一的检测方法能够区分良性和恶性浆细胞增殖。多发性骨髓瘤的临床特征是由单克隆丙种球蛋白病、浆细胞以及细胞分泌的细胞因子继发的组织损伤所致。由于正常免疫球蛋白水平降低，患者易受感染。对于50%至60%有反应的患者，美法仑和泼尼松方案可将中位生存期从7个月提高到3年。治愈极为罕见。难治性和耐药性多发性骨髓瘤患者应按照研究方案进行治疗。
在过去二十年中，我们对多发性骨髓瘤及相关浆细胞肿瘤生物学的理解有了实质性进展。我们有理由期待治疗会有所改善。
