老年多发性骨髓瘤治疗研究进展

Treatment strategy of elderly multiple myeloma

多发性骨髓瘤(multiple myeloma, MM)是一种恶性浆细胞病,常见于65岁以上老年人,目前尚无治愈方法。随着新药的不断出现,MM患者生存期明显延长,对年龄<65岁MM患者多采用大剂量化疗或自体造血干细胞移植等治疗,但对老年患者,因其体质上差异,大剂量化疗并不能改善其预后,且可增加死亡风险,因此临床对老年MM患者多通过老年评估工具进行体质评估,并按虚弱等级制定个体化的治疗方案。本文就老年MM患者治疗难度、老年体质评估及治疗方案选择的研究进展作一综述。

Multiple myeloma(MM) is a kind of malignant plasma cell disease, commonly occurring in patients aged over 65 years, and it still cannot be cured. With the invention of new anti-tumor drugs, the survival time of MM patients can be significantly prolonged. High-dose chemotherapy or autologous hematopoietic stem cell transplantation is usually used in MM patients aged over 65 years. Since the elderly patients differ in physical condition, high-dose chemotherapy might increase the risk for death without improving the prognosis. Geriatric assessment is often used in the comprehensive assessment of the physical condition of the elderly MM patients to formulate individualized treatment program based on the level of frailty. This paper reviews the research progress of the evaluation of the treatment difficulty, assessment of physique and the choice of treatment strategies in elderly MM patients.