高危冒烟型多发性骨髓瘤的风险分层及治疗进展  

Progress in risk stratification and treatment of high-risk smoldering multiple myeloma

作　　者：周洁琼 郝牧 安刚 Zhou Jieqiong;Hao Mu;An Gang(State Key Laboratory of Experimental Hematology,National Clinical Research Center for Blood Diseases,Haihe Laboratory of Cell Ecosystem,Institute of Hematology&Blood Diseases Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Tianjin 300020,China;Tianjin Institutes of Health Science,Tianjin 301600,China)

机构地区：[1]中国医学科学院血液病医院(中国医学科学院血液学研究所),血液与健康全国重点实验室,国家血液系统疾病临床医学研究中心,细胞生态海河实验室,天津300020 [2]天津医学健康研究院,天津301600

出　　处：《中华血液学杂志》2024年第12期1148-1152,共5页Chinese Journal of Hematology

基　　金：国家自然科学基金(82270218)。

摘　　要：冒烟型多发性骨髓瘤(SMM)患者是一个异质性群体,不同患者预后不一,部分高危患者2年内有较高风险向多发性骨髓瘤(MM)转化。高危患者的定义在不同风险模型间一致性不高,各种生物标志物与新技术的结合改善了风险模型的预测效能,临床研究中往往组合应用不同的风险模型。治疗MM的新药逐渐被应用于高危SMM的治疗中,单药或双药治疗延长了患者的无进展生存期,但多数研究尚未显示患者的总生存获益。多药联合、强化治疗能够使高危SMM实现深度缓解,但是多为单臂研究,尚不足以证明多药治疗疗效优于较低强度治疗,仍需进一步探索高危SMM患者的治疗方案。本文对高危SMM的风险分层及治疗进展进行综述。Smoldering multiple myeloma(SMM)patients are a heterogeneous group with variable prognosis.A subset of SMM patients have a higher risk of progressing to multiple myeloma(MM)within 2 years.The definition of high-risk patients is not consistent among different risk models,and the combination of various biomarkers and new technologies improves the predictive performance of risk models.In clinical research,different risk models are often combined and applied.New drugs for treating MM are gradually being applied in the treatment of high-risk SMM.Single or dual drug therapy prolongs the progression free survival of patients,but most studies have not yet shown an overall survival benefit for patients.Multi drug combination and intensive treatment can achieve deep relief in high-risk SMM,but most of the studies are single arm studies,which are not yet sufficient to prove that multi drug treatment is more effective than lower intensity treatment.Further exploration of treatment plans for high-risk SMM patients is still needed.This article reviews the progress in risk stratification and treatment of high-risk SMM.

关 键 词：多发性骨髓瘤 风险分层 高危患者 风险模型 多药治疗 强化治疗 生物标志物 治疗进展 

分 类 号：R733.3[医药卫生—肿瘤]