The outcome of multiple myeloma (MM) has significantly improved in the last few decades due to several factors such as new biological discoveries allowing to better stratify disease risk, development of more effective therapies and better management of side effects related to them. However, handling all these aspects requires an interdisciplinary approach involving multiple knowledge and collaboration of different specialists. The hematologist, faced with a patient with MM, must not only choose a treatment according to patient and disease characteristics but must also know when therapy needs to be started and how to monitor it during and after treatment. Moreover, he must deal not only with organ issues related to MM such as bone disease, renal failure or neurological disease but also with adverse events, often very serious, related to novel therapies, particularly new generation immunotherapies such as CAR T cell therapy and bispecific antibodies. In this review, we provide an overview on the newer MM diagnostic and monitoring strategies and on the main side effects of MM therapies, focusing on adverse events occurring during treatment with CAR T cells and bispecific antibodies.
过去几十年间，多发性骨髓瘤（MM）的预后显著改善，这得益于多种因素：新的生物学发现使疾病风险分层更精准、更有效的疗法不断涌现、治疗相关副作用的管理水平持续提升。然而，全面处理这些方面需要采用跨学科方法，整合多领域知识并促进不同专科医师的协作。血液科医师面对MM患者时，不仅需要根据患者个体特征和疾病特点选择治疗方案，还必须准确把握治疗启动时机，并掌握治疗期间及治疗后的监测方法。此外，医师不仅需要处理MM相关的器官损害（如骨病、肾功能衰竭或神经系统疾病），还需应对新型疗法——特别是嵌合抗原受体T细胞（CAR-T）疗法和双特异性抗体等新一代免疫疗法——所引发的严重不良事件。本综述将系统阐述MM的新型诊断与监测策略，重点分析CAR-T细胞疗法和双特异性抗体治疗过程中的主要不良反应，并对MM治疗相关副作用进行整体评述。
肿瘤(癌症)患者之家