CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题：Advances in the treatment of extramedullary disease in multiple myeloma.
Advances in the treatment of extramedullary disease in multiple myeloma.
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髓外疾病（EMD）的特征是多发性骨髓瘤（MM）患者骨髓外出现浆细胞，导致不良预后。治疗的基石包括联合治疗，包括蛋白酶体抑制剂、免疫调节剂、类固醇，随后对符合条件的患者进行巩固性自体造血干细胞移植。本综述总结了EMD治疗的最新进展。以硼替佐米为基础的治疗显示出疗效，并被推荐用于治疗EMD。Marizomib由于具有良好的中枢神经系统穿透性，在治疗中枢神经系统多发性骨髓瘤（CNS-MM）方面具有优势。免疫调节药物如来那度胺和泊马度胺已被报道有效。Isatuximab和selinexor也具有活性。基于我科EMD的治疗经验，我们总结了EMD的治疗方法。然而，EMD患者从新药时代中获益有限。新药联合、单克隆抗体、分子靶向治疗、细胞免疫治疗和自体干细胞移植（ASCT）正在研究中。应开展专门针对EMD的治疗研究和临床试验。希望这些EMD治疗选择在未来能被证明有效。
Extramedullary disease (EMD) is characterized by plasma cells outside of bone marrow in multiple myeloma (MM) patients, which results in an adverse prognosis. The cornerstone of treatment consists of combination therapy including proteasome inhibitors, immunomodulatory agents, steroids, followed by consolidative autologous hematopoietic stem cell transplantation in eligible patients. This review summarized the recent advances in the treatment of EMD.
Bortezomib based therapy showed efficacy and was recommended to treat EMD. Marizomib had advantages in the treatment of central nervous system-multiple myeloma (CNS-MM) because of its good central nervous system penetrability. Immunomodulatory drugs such as lenalidomide and pomalidomide have been reported to be effective. Isatuximab and selinexor were also active. Based on the treatment experience of EMD in our department, we summarized treatment approach for EMD.
However, the benefits of patients with EMD from the new era of novel drugs were limited. Novel drugs combination, monoclonal antibody, molecular targeted therapy, cellular immunotherapy and autologous stem cell transplantation (ASCT) are under investigation. Therapeutic studies and clinical trials specifically target EMD should be conducted. Hopefully, these treatment options for EMD will be demonstrated efficacy in the future.
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