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多发性骨髓瘤微小残留病检测与应用进展

Minimal residual disease assessment and progress in multiple myeloma

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多发性骨髓瘤的治疗药物在近20年来快速迭代,患者缓解率和缓解深度不断提高,传统的疾病疗效监测方法不能满足新药时代的临床需求.微小残留病(MRD)是一种更为敏感的用于评估疾病缓解深度的检测手段,多项临床试验数据和荟萃分析显示,相比较传统的完全缓解,MRD阴性与更好的预后相关,MRD驱动治疗也成为研究焦点.目前MRD评估涉及三个维度:基于骨髓克隆性浆细胞的MRD检测,基于局灶病变残留代谢活性的MRD检测,基于外周血的MRD检测.各个MRD的评估方法互为补充.本文旨在系统性介绍多发性骨髓瘤MRD检测方法与应用进展,为临床医师更好运用相关技术提供参考.
With the rapid iteration of multiple myeloma therapeutics over the last two decades,as well as increasing remission rates and depth of remission in patients,traditional methods for monitoring disease response are insufficient to meet the clinical needs of new drugs.Minimal residual disease(MRD)is a more sensitive test for determining the depth of response,and data from multiple clinical trials and meta-analyses show that a negative MRD correlates with a better prognosis than a traditional complete response.MM is at the forefront of MRD evaluation and treatment.MRD detection methods have been continuously updated.The current MRD assessment has three dimensions:bone marrow-based MRD testing,MRD testing based on images of residual metabolic of focal lesions,and peripheral blood-based MRD testing.The various MRD assessment methods complement one another.The goal of this article is to discuss the currently used MRD assays,the progress,and challenges of MRD in MM,and to provide a reference for clinicians to better use the techniques.

周慧星、陈文明

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首都医科大学附属北京朝阳医院血液科,北京市多发性骨髓瘤医疗研究中心,北京 100020

2024

中华血液学杂志
中华医学会

中华血液学杂志

CSTPCD北大核心
影响因子:1.17
ISSN:0253-2727
年,卷(期):2024.45(2)
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