复发难治性多发性骨髓瘤的药物治疗新进展

Progress in the Pharmacotherapy of Relapsed and Refractory Multiple Myeloma

多发性骨髓瘤(MM)是以浆细胞恶性克隆增殖为特征的一种血液系统恶性疾病,临床上属于难治性疾病。过去的数十年间,随着诱导方案联合自体干细胞移植治疗,MM患者的缓解率已经达到40%～60%,其5年和10年生存率亦分别从1975年的28.8%和11.1%升至2004年34.7%和17.4%。但现有的治疗手段仍无法治愈MM,如何提高复发难治性MM的疗效,是临床亟待解决的问题。目前尚无针对复发难治性MM的标准治疗方案。近年来,临床应用雷利度胺、硼替佐米以及其他新型药物为基础的单药或联合方案治疗该类疾病已经取得了较好的疗效,本文就近年来的药物治疗进展综述如下。

Multiple myeloma （MM） is characterized by the accumulation of clonally identical plasma cells in the bone marrow. The response rate and overall survival （OS） of MM patients over the past decades have improved as a result of induction regimens after autologous stem cell transplantation. The overall remission rate ranges from 40% to 60%. The 5- and 10- year OS rates have increased from 28.8% and 11.1% in 1975 to 34.7% and 17.4% in 2004, respectively. However, MM remains an incurable disease. All MM pa- tients inevitably relapse or develop refractory diseases. The curative effect of drugs for MM urgently needs to be improved significant- ly. At present, a generally accepted standard treatment plan for MM patients is still unavailable. The current review provides an over- view of various treatment strategies, including new drugs with remarkable efficacies, which have been available over the past years for relapsed/refractory MM.