文章：

多发性骨髓瘤自体干细胞移植的现状

Current status of autologous stem cell transplantation for multiple myeloma

原文发布日期：2019-04-08

DOI: 10.1038/s41408-019-0205-9

类型: Review Article

开放获取: 是

英文摘要：

More than 30 years after its introduction, autologous stem cell transplantation (ASCT) remains the standard of care for young patients with newly diagnosed multiple myeloma. Not only did the arrival of novel agents such as immunomodulatory drugs (IMiDs), proteasome inhibitors (PI) and monoclonal antibodies not replace ASCT, instead they solidified its central role as standard of care. Novel agent use is now inarguably essential in induction, maintenance, and possibly consolidation. In light of these new advancements, new challenges arise in deciding on optimal practice. Who is most suited to undergo ASCT? Is there an age threshold that should not be surpassed? Should transplantation be embarked on early or is it reasonable to delay it? What are the optimal induction, consolidation, and maintenance therapies? What is the role of tandem transplantation in the era of novel agents and where do patient-specific cytogenetics come into the equation when deciding on treatment? These are some of the questions addressed in this review which we will attempt to answer with the latest currently available data.
 

摘要翻译： 

自体干细胞移植（ASCT）问世三十余年来，始终是新诊断年轻多发性骨髓瘤患者的标准疗法。即便免疫调节药物、蛋白酶体抑制剂及单克隆抗体等新型药物相继问世，也未能取代ASCT的地位，反而巩固了其作为标准治疗的核心作用。目前新型药物在诱导、维持乃至巩固治疗阶段的重要性已毋庸置疑。随着这些新进展的出现，临床实践面临新的挑战：哪些患者最适合接受ASCT？是否存在不应逾越的年龄界限？应尽早实施移植还是推迟移植更具合理性？最佳的诱导、巩固及维持治疗方案是什么？在新型药物时代，序贯移植的价值如何定位？患者特异性细胞遗传学在治疗决策中又应如何考量？本篇综述将基于当前最新数据，对上述问题展开探讨。

原文链接：

Current status of autologous stem cell transplantation for multiple myeloma