伴髓外病变的多发性骨髓瘤的诊治进展

Advances in diagnosis and treatment of multiple myeloma with extramedullary disease

伴髓外病变（EMD）的多发性骨髓瘤（MM）为MM患者存在骨髓外浆细胞的浸润.DC（Durie-Salmon）-PLUS分期系统新纳入EMD因素对MM患者进行预后评估.临床上推荐全身MRI与正电子发射断层显像（PET）/CT为伴EMD的MM患者诊断与疗效评估的工具.伴EMD提示初诊与复发MM患者的预后不良.伴EMD的MM患者预后较差,复发的伴EMD的MM患者的中位总体生存（OS）期＜6个月.伴EMD的MM为高风险骨髓瘤,临床应该予以积极治疗.为了增强对伴EMD的MM诊治的认识,笔者拟就伴EMD的MM患者的临床表现特点及诊治方法进行综述.

Multiple myeloma （MM） with extramedullary disease （EMD） is defined as the infiltration of plasma cells outside the bone marrow in MM patients.The new EMD factor for prognosis of MM patients is added into the DS （Durie-Salmon）-PLUS staging system.It is recommended that whole body MRI and positron emission tomography （PET）/CT should be used to evaluate initial status and treatment efficacy in MM patients with EMD in the clinical.MM patients with EMD,including new diagnosed and relapsed MM patients are associated with adverse prognosis.Prognosis of the MM with EMD is poor,and the median overall survival （OS） of patients with recurrence is less than 6 months.MM with EMD is a high-risk myeloma and should be treated aggressively.In order to enhance the understanding of the diagnosis and treatment in MM patients with EMD,this article summarizes the clinical characteristics,diagnosis and treatment of the MM patients with EMD.