摘要
多发性骨髓瘤(MM)是一种浆细胞异常克隆增殖的恶性疾病,是血液恶性肿瘤中第二常见的肿瘤,由于疾病的易复发及难治性,绝大多数患者无法治愈。近年来随着新药的开发以及造血干细胞移植的应用,MM的无进展生存期(PFS)及总生存期(OS)延长。MM通常局限于骨髓内,当克隆性浆细胞在远离骨髓生长或从突破皮质骨的骨病变邻近迁移浸润,就会形成MM的髓外病变(EMD)。EMD的预后极差。本文综述了免疫调节剂、蛋白酶体抑制剂、嵌合抗原受体T细胞(CAR-T)免疫治疗、双特异性抗体(BsAbs)免疫治疗、自体造血干细胞移植等治疗,以期对EMD的治疗提供新思路。
Multiple myeloma(MM)is a malignant disease characterized by abnormal clonal proliferation of plasma cells,ranking as the second most common hematologic malignancy.Due to its relapsing and refractory nature,the majority of patients remain incurable.In recent years,the development of novel agents and the application of hematopoietic stem cell transplantation have significantly prolonged progression-free survival(PFS)and overall survival(OS)in MM.While MM typically remains confined to the bone marrow,extramedullary disease(EMD)occurs when clonal plasma cells proliferate at sites distant from the bone marrow or infiltrate adjacent tissues by breaching cortical bone.EMD is associated with an extremely poor prognosis.This review summarizes current therapeutic strategies for EMD,including immunomodulatory drugs,proteasome inhibitors,chimeric antigen receptor T-cell(CAR-T)immunotherapy,bispecific antibodies(BsAbs),and autologous hematopoietic stem cell transplantation,aiming to provide novel insights into the management of EMD.
作者
汪露
胡蓓莉
Wang Lu;HuBeili(Jiaxing University Master Degree Cultivation Base,Zhejiang Chinese Medical University,Jiaxing,Zhejiang 314000,China;Department of Hematology,Second Affiliated Hospital of Jiaxing University,Jiaxing,Zhejiang 314000,China)
出处
《中国药物与临床》
2025年第12期798-806,共9页
Chinese Remedies & Clinics
关键词
多发性骨髓瘤
蛋白酶体抑制剂
免疫疗法
造血干细胞移植
Multiple myeloma
Protease inhibitors
Immunotherapy
Hematopoietic stem cell transplantation
