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免疫治疗时代将姑息治疗整合至复发/难治性多发性骨髓瘤:叙述性综述

英文原题:Integrating Palliative Care into Relapsed/Refractory Multiple Myeloma in the Immunotherapy Era: A Narrative Review.

查看英文原题

Integrating Palliative Care into Relapsed/Refractory Multiple Myeloma in the Immunotherapy Era: A Narrative Review.

PubMed 2026/09/03(内容时间) J Pain Palliat Care Pharmacother Q3 · IF 1.3(JCR 2025)

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中文摘要

复发/难治性多发性骨髓瘤(RRMM)已被T细胞重定向免疫疗法所改变,包括CAR-T 细胞疗法和双特异性抗体。尽管在重度经治患者中取得了前所未有的缓解率,但这些治疗带来了复杂且持续的毒性、巨大的后勤需求以及生存困境。在此背景下,姑息治疗的整合仍未被充分探索。我们采用系统式检索方法对PubMed/MEDLINE和Web of Science进行了叙述性综合,识别出315条记录。经过去重以及标题和摘要筛选后,51篇报告接受了全文审查。共纳入18项原始研究,并补充12篇参考文献以提供背景支持,最终共获得30条引文。出现了六个主题领域:姑息治疗在RRMM中的相关性;生活质量和患者报告结局;免疫治疗期间的支持性和姑息治疗挑战;沟通与共享决策;照护者负担;以及整合的实践模式。在RRMM免疫治疗中,早期、同步整合姑息治疗是有依据且可行的,应进行前瞻性评估。

展开英文摘要原文

Relapsed/refractory multiple myeloma (RRMM) has been transformed by T-cell-redirecting immunotherapies, including chimeric antigen receptor T-cell therapy and bispecific antibodies. Despite unprecedented response rates in heavily pretreated patients, these treatments impose complex and sustained toxicities, substantial logistical demands, and existential distress. Palliative care integration in this setting remains underexplored.

We conducted a narrative synthesis using a systematic-style search of PubMed/MEDLINE and Web of Science, identifying 315 records. After deduplication and title and abstract screening, 51 reports underwent full-text review. Eighteen primary studies were included, and 12 supplementary references were added for contextual support, yielding 30 citations overall.

Six thematic domains emerged: the relevance of palliative care in RRMM; quality of life and patient-reported outcomes; supportive and palliative care challenges during immunotherapy; communication and shared decision-making; caregiver burden; and practical models for integration. Early, concurrent palliative care integration in RRMM immunotherapy is warranted and feasible and should be evaluated prospectively.

论文信息

作者
Alzahrani M、Alsharif ZM、Alzahrani Z
第一作者单位
Ministry of Health, Jeddah, Saudi Arabia.Saudi Arabia
通讯作者单位
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.Saudi Arabia
文献类型
综述
期刊
Journal of pain & palliative care pharmacotherapy2026 Sep 3
原文标识
PubMed 42693623 · DOI 10.1080/15360288.2026.2725826