Multiple Myeloma
Category: 血液ICD-10: C90
Overview
Multiple myeloma is a blood cancer characterized by clonal proliferation of plasma cells in the bone marrow. It typically affects older adults with a median age at diagnosis of about 70 years. The disease is defined by M-protein production and bone destruction.
Symptoms
Bone pain (especially in the back and ribs), pathological fractures, and fatigue from anemia are hallmark symptoms. Kidney dysfunction, hypercalcemia, and recurrent infections also commonly occur.
Diagnosis
Serum and urine protein electrophoresis detect M-protein, and bone marrow biopsy confirms clonal plasma cell expansion. PET-CT or whole-body MRI evaluates bone lesions and disease extent.
Treatments
Transplant-eligible patients receive induction therapy (VRd: bortezomib, lenalidomide, dexamethasone) followed by autologous stem cell transplantation. Transplant-ineligible patients are treated with daratumumab-based regimens. Lenalidomide maintenance is widely used post-treatment.
Latest Research & Approaches
Anti-BCMA CAR-T cell therapies (idecabtagene vicleucel, ciltacabtagene autoleucel) show remarkable response rates in relapsed/refractory disease. Bispecific antibodies (teclistamab, elranatamab) offer additional options.
Sources & References
NCI - Multiple Myeloma Treatment
International Myeloma Foundation
NCCN Guidelines: Multiple Myeloma
International Myeloma Foundation
NCCN Guidelines: Multiple Myeloma