多发性骨髓瘤生物学和临床诊治的新视野:第56届美国血液学会年会报道

多发性骨髓瘤(MM)是一种从癌前状态(意义不明的单克隆免疫球蛋白血症MGUS)到恶性疾病转化过程的独特肿瘤.在其发病过程中,肿瘤克隆的基因型特点与浆细胞与其微环境之间的对话同样重要.MM基因是高度复杂和异质性的,它们对疾病的转归起着关键的作用,不久以后MM可能将不再被视为一个单一的疾病.大量新药的应用,将增加对微小残留病监测预后和治疗效果的预期和需要.新药和高剂量化疗联合自体干细胞移植的应用使MM的预后已经在过去20年得到显著改善,重新审视早期MM的诊断标准和早期干预的可能性将开辟新的治疗途径.新药物的不断涌现,将促使人们平衡疗效、毒性和成本之间的关系,以达到最佳的治疗目标.

New insights into the biology and clinical progress of multiple myeloma : reports from the 56th American Society of Hematology annual meeting

Multiple myeloma (MM) is a unique cancer paradigm for investigating the mechanisms involved in the transformation from a premalignant condition (unknown monoclonal gamma globulin,MGUS) into a malignant disease (MM).In its pathogenesis,genotype characteristics of tumor clones which are highly complex and heterogeneous,as well as the dialogue between plasma cells and their microenvironment are equally important and both play a key role in the outcome of the disease.MM will soon no longer be considered as a single disease.A large number of new drug emergence and applications will increase the need for monitoring minimal residual disease (MRD) in prognosis and treatment of MM.New drugs and high-dose chemotherapy with autologous stem cell transplantation applications have been significantly improving the prognosis of MM in the past 20 years.Re-examining the early MM diagnostic criteria and the possibility of early intervention will open up a new therapeutic approach.It is important to find a balance of efficacy,toxicity and cost in order to achieve a cure for this disease.