CAJ | 학술논문

背景:近年来,多发性骨髓瘤发病率有所增长,然而治疗相当棘手.造血干细胞移植技术不断改进,新的药物应用于临床,以及移植联合新药治疗,为患者带来新的希望.目的:总结近年来造血干细胞移植及其与新药联用方案治疗难治性多发性骨髓瘤的新进展.方法:应用计算机检索PubMed、ISI平台BP+Medline数据库及万方、维普数据库1990年1月至2012年4月有关造血干细胞移植及免疫调节剂、蛋白酶体抑制剂联合移植的文献报道,排除陈旧的、内容重复的文章.结果与结论:检索及筛选后保存22篇中英文文献,并对其进行分析,得出造血干细胞移植以及联合新药的治疗策略使得大剂量化疗和自体干细胞移植治疗的效果得到显著改善.移植前加用新药诱导和移植后用新药维持治疗可以延缓进展期,提高总体生存率.异基因造血干细胞移植治疗可以使多发性骨髓瘤患者获得长期的分子生物学缓解并治愈.多种治疗方法的组合及优缺点比较,可更好的为临床医师在实践中根据患者实际情况进行决策,最大程度满足患者的需要.
배경:근년래,다발성골수류발병솔유소증장,연이치료상당극수.조혈간세포이식기술불단개진,신적약물응용우림상,이급이식연합신약치료,위환자대래신적희망.목적:총결근년래조혈간세포이식급기여신약련용방안치료난치성다발성골수류적신진전.방법:응용계산궤검색PubMed、ISI평태BP+Medline수거고급만방、유보수거고1990년1월지2012년4월유관조혈간세포이식급면역조절제、단백매체억제제연합이식적문헌보도,배제진구적、내용중복적문장.결과여결론:검색급사선후보존22편중영문문헌,병대기진행분석,득출조혈간세포이식이급연합신약적치료책략사득대제양화료화자체간세포이식치료적효과득도현저개선.이식전가용신약유도화이식후용신약유지치료가이연완진전기,제고총체생존솔.이기인조혈간세포이식치료가이사다발성골수류환자획득장기적분자생물학완해병치유.다충치료방법적조합급우결점비교,가경호적위림상의사재실천중근거환자실제정황진행결책,최대정도만족환자적수요.
@@@@ BACKGROUND:In recent years, the morbidity of multiple myeloma is increased;however, this disease cannot be cured now. With the improvements in hematopoietic stem cel s transplantation technology and clinical application of new drugs, as wel as cel transplantation treatment combined with new drug application, multiple myeloma patients wil have new hope in their lives. OBJECTIVE:To summarize the progress of refractory multiple myeloma treatment by hematopoietic stem cel s transplantation combined with new drug therapy in recent years. METHODS:A computer-based search was performed on PubMed database, ISI platform BP+Medline database, Wanfang database and VIP database for articles describing hematopoietic stem cel s transplantation and immunoregulant, protease inhibitors combined cel transplantation published during January 1990-April 2012. Articles with obsolete and repeated contents were rejected. RESULTS AND CONCLUSION:A total of 22 articles in Chinese and English were obtained after retrieval and screening. Analysis of retrieved articles shows that hematopoietic stem cel s transplantation combined with new drug treatment strategy can greatly improve the effects of high-dose chemotherapy and autologous stem cel transplantation treatment. Pre-transplantation induction with new drug application and post-transplantation maintenance with new drug can delay the progression and enhance the overal survival rates. Al ogeneic hematopoietic stem cel transplantation therapy wil achieve long-term molecular biological relief and therapeutic effects in multiple myeloma patients. The combination of a variety of treatment methods and the comparison between the advantages and disadvantages can help the clinicians to make better decision-making in practice according to real situation of the patients, and can satisfy the needs of patients.