新诊断的多发性骨髓瘤的治疗选择

根据国际骨髓瘤工作组（IMWG）关于骨髓瘤的最新分类可以将多发性骨髓瘤（MM）大致分为两类：无症状骨髓瘤（冒烟型骨髓瘤）和有症状的MM。前者相当于Durie-Salmon（DS）I期，此类患者不需要治疗，只需定期复查和观察；后者相当于DSⅡ、Ⅲ期，需要立即进行治疗。2007年美国国家综合癌症网络协会（NCCN）建议Ⅱ期或Ⅲ期、机体状态良好的MM患者行自体干细胞移植（ASCT）。因此应根据是否适合行ASCT对新诊断MM患者选择不同的诱导治疗方案。

Therapeutic options for newly diagnosed multiple myeloma

According to the latest classification of International Myeloma Working Group(IMWG),multiple myeloma(MM)is roughly classified into two groups,asymptomatic myeloma(smoldering myeloma)and symptomatic myeloma.The former is equal to the stage Ⅰ of Durie-Salmon(DS),and patients of this type only wait and see,and do not need any therapy.The later is equal to stage Ⅱ and Ⅲ of DS,and patients of this type need therapy immediately.Autologous stem cell transplantation(ASCT)is recommended by National Comprehensive Cancer Network(NCCN)for patients with stage Ⅱ or Ⅲ myeloma with good performance status in 2007.Different therapeutic regiwen should he selected for newly diagnosed MM patients according to whether ASCT is suitable or not.