微小残留病检测在多发性骨髓瘤移植后患者中的应用现状与思考

Application status and thinking of minimal residual disease-monitoring in multiple myeloma after stem cell transplantation

多发性骨髓瘤(multiple myeloma,MM)患者的治疗疗效在近十年来不断提高,特别是在新药联合移植治疗后,其无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS)均大幅延长。对于患者的疗效而言,传统意义的评效标准完全缓解(complete response,CR)已经不能满足其对预后的指导,微小残留病(minimal residual disease,MRD)的评估应运而生,其检测方法发展较快。血清游离轻链(serum free light chain,sFLC)、流式细胞术、聚合酶链式反应(polymerase chain reaction,PCR)、二代测序(next-generation sequencing,NGS)和PET-CT等各项技术层出不穷。本文就上述各检测手段在MM移植后患者中的应用现状予以综述。

The efficacy of multiple myeloma （MM） treatments, particularly novel medicines and transplantation, has improved rapidly in the last ten years, with increasing rates of progression-free survival （PFS） and overall survival （OS）. However, complete response （CR） is not enough as prognostic indicator guidance. Therefore, methods have been developed to monitor minimal residual disease （MRD）, such as serum free light chain （sFLC）, flow cytometry, polymerase chain reaction （PCR）, next generation sequencing （NGS）, and PET-CT. This article reviewed the current situation of the application of those methods in MM patients after stem cell transplantation.