多发性骨髓瘤骨病的治疗进展

Progress in Treatment of Multiple Myeloma Bone Disease

多发性骨髓瘤是B淋巴细胞来源的浆细胞克隆性增生的恶性肿瘤,而骨髓瘤骨病(MBD)是其进展的重要临床表现。MBD的发病机制主要与破骨细胞活性明显增加、成骨细胞功能受抑制有关。随着MBD致病机制研究的进一步深入,MBD的临床治疗从传统的联合化疗和放射治疗,进展到应用双膦酸盐类药物、手术等治疗方式。现阶段已逐渐出现或正处于临床试验阶段的新型蛋白酶体抑制剂或靶向治疗药物,如卡非佐米、骨硬化蛋白抗体、巨噬细胞炎症蛋白1α抗体等。这些药物能明显延缓MBD的进展,且不良事件发生率较低。未来,明确MBD的致病机制、开发新型靶向治疗药物及多靶联合治疗成为MBD的研究方向和重点。

Multiple myeloma is a malignant tumor of B lymphocyte-derived clonal cell proliferation and myeloma bone disease（MBD） is an important clinical manifestation of its progress. The pathogenesis of MBD is mainly related to the increase in osteoclast activity and the inhibition of osteoblast function. With a further study of pathogenesis of MBD, the clinical treatment of MBD from the traditional combination of chemotherapy and radiation therapy is progressing to the appli- cation of bisphosphonates drugs, surgery and other treatment methods. Currently, the emerging new proteasome inhibitors or targeted therapeutic agents include carfiiZomib, bone selerbsis protein antibody, rnaerophage inflammatory protein-1α, some of which are in clinical trials. These drugs can significantly delay the progress of MBD ,with low incidence of adverse events. In the future, clarifying the pathogenesis of MBD, the development of new targeted therapy and multi-target combination therapy will be the research direction and focus of MBD .,