高危多发性骨髓瘤病人的治疗
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">高危多发性骨髓瘤<span style="color: black;">病人</span>的治疗</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">北京朝阳医院西院</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">胡影</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="http://mmbiz.qpic.cn/mmbiz/1AjicxSdpJA5KHa1YiaERl5DKRSpGaibX6Addx3bV46ia8lln018pLrQhxIEr0CadNmqLuibgcbmZG5t7PN5sibibGibSQ/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">国际多发性骨髓瘤工作组<span style="color: black;">近期</span>更新了基于细胞遗传学<span style="color: black;">反常</span>对高危多发性骨髓瘤<span style="color: black;">病人</span>的定义。<span style="color: black;">细胞遗传学<span style="color: black;">反常</span> t(4;14), del(17/17p), t(14;16), t(14;20), 亚二倍体和 1q+被一致确认为不良预后<span style="color: black;">原因</span></span>。<span style="color: black;">拥有</span>这些遗传学<span style="color: black;">反常</span>的<span style="color: black;">病人</span>会因治疗<span style="color: black;">方法</span>的不同而预后不同。能够克服遗传学<span style="color: black;">反常</span>的治疗策略<span style="color: black;">包含</span>蛋白酶体<span style="color: black;">控制</span>剂（如万珂）联合来那度胺或泊马度胺，双次自体干细胞移植联合硼替佐米或来那度胺或泊马度胺。基于<span style="color: black;">日前</span>的数据，<span style="color: black;">硼替佐米和卡非佐米能够<span style="color: black;">加强</span>伴 t(4;14) 和del(17/17p)<span style="color: black;">病人</span>的完全缓解率，延长<span style="color: black;">没</span><span style="color: black;">发展</span><span style="color: black;">存活</span>时间和总<span style="color: black;">存活</span>时间</span><span style="color: black;">。来那度胺可能延长伴t(4;14) 和del(17/17p)<span style="color: black;">病人</span>的的<span style="color: black;">没</span><span style="color: black;">发展</span><span style="color: black;">存活</span>时间。</span>然而<span style="color: black;">拥有</span>多个不良细胞遗传学<span style="color: black;">反常</span>的<span style="color: black;">病人</span><span style="color: black;">不可</span>从这些新药中获益。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">按照</span>最新的文献数据及<span style="color: black;">咱们</span>中心的经验<span style="color: black;">意见</span>骨髓瘤<span style="color: black;">病人</span>：</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">进行常规的FISH检测，有利于后续的预后分层及治疗</strong>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;"><span style="color: black;">伴同</span>高危染色体<span style="color: black;">反常</span>的<span style="color: black;">病人</span>，<span style="color: black;">意见</span>采用含新药的治疗<span style="color: black;">方法</span>，如硼替佐米或来那度胺</strong>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">数据来自：Sonneveld P,Treatment of Multiple Myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group.Blood. 2016.Mar 21</p><strong style="color: blue;"><span style="color: black;">朝阳医院西院血液科（血和尿）M蛋白鉴定的检测时间：每周三上午九点前检测，周五出结果</span></strong>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="http://mmbiz.qpic.cn/mmbiz/1AjicxSdpJA4lqknpYribZ8jywTFUA9795vJTaEbz4F91aWia4RxZZHibcIndgPh9icnjK8AibkbgResibMU0cuz9iagHA/640?wx_fmt=jpeg&tp=webp&wxfrom=5&wx_lazy=1&wx_co=1" style="width: 50%; margin-bottom: 20px;"></p>
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