In recent years, there have been major advances in the treatment of multiple myeloma. Among previously untreated patients, different combinations of dexamethasone, lenalidomide, thalidomide, and bortezomib have produced overall response rates of 80%-90% with complete response rates of 10%-32%, and remissions are often achieved after only 2 cycles of initiating systemic therapy. Subsequent intensification with high-dose chemotherapy supported by autologous stem cell transplantation has enabled younger patients to achieve partial and complete responses with evidence of prolonged survival. Tandem autologous stem cell transplantation and reduced-intensity allogeneic stem cell transplantation are under investigation in attempts to improve outcomes. For patients unable to pursue consolidation therapy with stem cell transplantation, remissions obtained with induction therapy can often be extended with the use of maintenance systemic therapy. Despite available therapies, relapse of disease is inevitable for nearly all patients, and treatment strategies with novel agents and novel combinations of established agents are under study.

译文

:近年来,多发性骨髓瘤的治疗取得了重大进展。在先前未接受治疗的患者中,地塞米松,来那度胺,沙利度胺和硼替佐米的不同组合产生的总缓解率为80%-90%,完全缓解率为10%-32%,并且通常仅在2个周期的全身性启动后即可缓解治疗。自体干细胞移植支持的大剂量化疗随后的强化治疗使年轻患者能够获得部分和完全缓解,并具有延长生存期的证据。串联自体干细胞移植和强度降低的异体干细胞移植正在研究中,以期改善治疗效果。对于无法通过干细胞移植进行巩固治疗的患者,诱导治疗获得的缓解通常可通过维持全身治疗来扩大。尽管有可用的疗法,对于几乎所有患者来说疾病的复发都是不可避免的,并且正在研究用新型药物和已建立药物的新型组合的治疗策略。

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