文章：

低剂量全身CT在监测冒烟型多发性骨髓瘤病情进展中的作用

The Role of Low Dose Whole Body CT in the Detection of Progression of Patients with Smoldering Multiple Myeloma

原文发布日期：2020-09-25

DOI: 10.1038/s41408-020-00360-9

类型: Article

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英文摘要：

Multiple myeloma (MM) is the second most common hematological malignancy, characterized by plasma cell bone marrow infiltration and end-organ involvement. Smoldering MM (SMM) is an intermediate clinical entity between MGUS and MM, with a risk of progression to symptomatic disease 10% per year. Bone disease is the most frequent symptom of MM, with ~90% of patients developing bone lesions throughout their disease course. Therefore, imaging plays a crucial role in diagnosis and management. Whole-body low-dose CT (WBLDCT) is widely available and has been incorporated in the latest diagnostic criteria of the IMWG. The purpose of this study was to evaluate the role of WBLDCT in the early identification of lesions in patients with SMM who progress solely with bone disease. In total, 100 asymptomatic patients were consecutively assessed with WBLDCT from July 2013 until March 2020 at baseline, 1-year after diagnosis and every 1 year thereafter. Ten percent of patients were identified as progressors with this single imaging modality. This is the first study to evaluate prospectively patients with SMM at different time points to identify early bone lesions related to MM evolution. Serial WBLDCT studies can identify early myeloma evolution and optimize disease monitoring and therapeutic strategies.
 

摘要翻译： 

多发性骨髓瘤（MM）是第二常见的血液系统恶性肿瘤，其特征是浆细胞骨髓浸润及终末器官受累。冒烟型骨髓瘤（SMM）是介于意义未明单克隆丙种球蛋白病（MGUS）与MM之间的中间临床状态，每年进展为症状性疾病的风险为10%。骨病是MM最常见的症状，约90%患者在病程中会出现骨病变。因此，影像学检查在诊断和管理中至关重要。全身低剂量CT（WBLDCT）应用广泛，已被纳入国际骨髓瘤工作组（IMWG）最新诊断标准。本研究旨在评估WBLDCT在早期识别仅伴骨病变进展的SMM患者病灶中的作用。2013年7月至2020年3月期间，共对100例无症状患者连续进行WBLDCT评估，分别在基线、诊断后1年及之后每年进行。通过这种单一影像学方法识别出10%的患者为进展者。这是首个在不同时间点前瞻性评估SMM患者以识别MM演变相关早期骨病变的研究。系列WBLDCT研究可早期识别骨髓瘤演变，优化疾病监测和治疗策略。

原文链接：

The Role of Low Dose Whole Body CT in the Detection of Progression of Patients with Smoldering Multiple Myeloma