多发性骨髓瘤的治疗现状和规范

多发性骨髓瘤(MM)是一种异常浆细胞过度增殖的恶性肿瘤,传统化疗效果不佳,完全缓解率(CR)＜10％,中位生存期仍然只有33个月左右.自体造血干细胞移植(ASCT)的应用改善了MM的疗效,含新药的诱导化疗能达到与移植相似的疗效.目前认为,含新药的诱导治疗序贯ASCT是≤65岁适合移植的初治MM患者的治疗策略,单次移植后疗效≥非常好的部分缓解的患者不需要二次移植.移植后的巩固和维持治疗是有益的.对于＞65岁及不适合移植的初治MM患者,含新药的诱导治疗和维持治疗同样是合适的.

Updates on treatment and standard of multiple myeloma

Multiple myeloma（MM） is a malignant cancer with excessive proliferation of abnormal plasma cells.Conventional chemotherapy is poorly effective against MM;less than 10 ％ of patients have complete remission（CR） and the median survival period is only about 33 months.The application of autologous hematopoietic stem cell transplantation（ASCT） has dramatically improved MM outcome.The novel-agent-based therapies have also improved the prognosis.Therefore,sequential novel-agent-based treatment followed by ASCT is regarded as effective treatment for MM patients under the age of 65 years.The patients with the post-transplantation efficacy ≥very good partial remission do not benefit from a second transplantation.Consolidation and maintenance therapy post-ASCT is beneficial.Novel-agent-based induction and maintenance therapy is also suitable for MM patients above the age of 65 years.