循环浆细胞在多发性骨髓瘤患者中的临床意义及预后作用

Circulating Plasma Cells in Multiple Myeloma: Clinical Implications and Prognostic Significance

多发性骨髓瘤(Multiple myeloma, MM)是一种浆细胞恶性克隆性疾病,仅次于淋巴瘤的第二常见的血液系统恶性肿瘤。其诊断取决于骨髓中异常单克隆浆细胞的识别,血清或尿液中的单克隆M蛋白,终末器官损伤的证据以及与MM一致的临床表现。尽管开发了新的靶向治疗策略,MM仍是一种不可治愈的疾病,目前多药联合化疗后行自体造血干细胞移植仍被认为是年轻MM患者的一线标准治疗方案。MM患者的外周血可能含有循环浆细胞,可以通过流式细胞术等多种方法检测,循环浆细胞在骨髓瘤患者中的存在仍然是一个值得讨论的话题。因此,本文将从循环浆细胞的检测方法、对MM患者的影响、影响循环浆细胞的因素等方面做一综述。

Multiple myeloma (MM) is a malignant clonal proliferation of plasma cells and is the second most common haematological malignancy after lymphoma. Its diagnosis relies on the identification of abnormal monoclonal plasma cells in the bone marrow, the detection of monoclonal M protein in serum or urine, evidence of end-organ damage and the observation of clinical manifestations consistent with MM. Despite advances in targeted therapy, MM remains an incurable disease. Currently, autologous haematopoietic stem cell transplantation (auto-HSCT) following combination chemotherapy is advocated as the frontline treatment for younger patients with MM. Circulating plasma cells (CPCs) may be present in the peripheral blood of MM patients and can be detected by methods such as flow cytometry. The presence of CPCs in myeloma patients remains controversial. Therefore, this article attempts to provide a comprehensive review of CPC detection methods, their impact on MM patients, and the factors influencing CPC levels.