RESEARCH PROGRESS IN THE DIAGNOSIS AND TREATMENT OF MULTIPLE MYELOMA
Keywords:
Multiple myeloma, Diagnosis, TreatmentAbstract
Multiple myeloma (MM) is a hematologic disorder characterized by clonal abnormal proliferation of malignant plasma cells in the bone marrow, accompanied by the presence of monoclonal immunoglobulins or their fragments in the blood and urine. The most important tools for diagnosing MM include molecular diagnosis, bone marrow cytology, and imaging, etc. The early symptoms of MM are atypical and easily misdiagnosed or missed, and need to be combined with several laboratory tests to make a comprehensive judgment. In recent years, research on oncogenesis, cytogenetics and molecular biology has been fruitful, and a variety of biomarkers such as microRNA, circulating tumor cells, circulating free DNA, circulating tumor DNA, etc. have been found to be related to multiple myeloma, which can be used for the auxiliary diagnosis of MM, predicting disease progression or for subsequent therapeutic targets. And with the development of science and technology, artificial intelligence and machine learning can also assist physicians in analysis and diagnosis. Meanwhile, monoclonal antibody therapies, targeting B-cell maturation antigens, etc. have also been shown to have better clinical efficacy in the treatment of multiple myeloma. The purpose of this article is to review the laboratory tests that are important for the diagnosis of multiple myeloma and the treatment options for the disease, to provide a basis and direction for the clinical diagnosis and treatment of multiple myeloma, and to improve the detection rate and efficacy of multiple myeloma.References
[1] Kumar S K, Rajkumar V, Kyle R A, et al. Multiple myeloma. Nature Reviews Disease Primers, 2015, 1: 15065.
[2] Mikhael J R, Dingli D, Roy V, et al. Management of newly diagnosed symptomatic multiple myeloma: updated Mayo Stratification of Myeloma and Risk-Adapted Therapy (mSMART) consensus guidelines. Mayo Clinic Proceedings, 2016, 91(1): 77-84.
[3] Rajkumar S V, Dimopoulos M A, Palumbo A, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol, 2014, 15(12): e538-e548.
[4] Zhang Yuping, Wang Junhua, Zhang Rui. Research progress in the diagnosis of MM. Chinese Journal of Practical Internal Medicine, 2018, 34(3): 229-233.
[5] Wu Z, Zhu L, Liao H, et al. Efficient real-time polymerase chain reaction detection of plasma markers in multiple myeloma. Biomedical Engineering, 2017, 83: 125-132.
[6] Sevcikova S, Kubiczkova L, Sedlarikova L, et al. Serum miR-29a as a marker of multiple myeloma. Leukemia & lymphoma, 2013, 54(1): 189-191.
[7] Guo C, Chénard-Poirier M, Roda D, et al. Intermittent schedules of the oral RAF–MEK inhibitor CH5126766/VS-6766 in patients with RAS/RAF-mutant solid tumours and multiple myeloma: A single-centre, open-label, phase 1 dose-escalation and basket dose-expansion study. The lancet Oncology, 2020, 21(11): 1478-1488.
[8] Wang W, Corrigan-Cummins M, Barber E A, et al. Aberrant levels of miRNAs in bone marrow microenvironment and peripheral blood of myeloma patients and disease progression. The Journal of Molecular Diagnostics, 2015, 17(6): 669-678.
[9] Bockorny B. Circulating Tumor Cells and Cell-Free DNA: Evidence-Based Clinical Applications in Multiple Myeloma. Current Hematologic Malignancy Reports, 2018, 13(3): 228-236.
[10] Paiva B. Clinical implications of circulating tumor cells in multiple myeloma. British Journal of Haematology, 2013, 160(3): 303-314.
[11] Nair B. Circulating Tumor Cells in Multiple Myeloma: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 2019, 8(10): 1546.
[12] Pawlyn C, Morgan G J, Evolution I I. Application of circulating tumor DNA in multiple myeloma for minimal residual disease detection and beyond. Expert Review of Molecular Diagnostics, 2016, 16(2): 205-217.
[13] Kubiczkova L, Kryukov F, Slaby O. Circulating serum microRNAs as novel diagnostic and prognostic biomarkers for multiple myeloma and monoclonal gammopathy of undetermined significance. Haematologica, 2014, 99(3): 511-518.
[14] Mithraprabhu S, Morley R, Khong T. Monitoring tumour burden and therapeutic response through analysis of circulating tumour DNA and extracellular RNA in multiple myeloma patients. Leukemia, 2017, 31(9): 2040-2046.
[15] Corcoran RB, Chabner BA. Application of cell-free DNA analysis to cancer treatment. N Engl J Med, 2018, 378(20): 1966-1978.
[16] Thierry AR, El Messaoudi S, Mollevi C, et al. Clinical utility of circulating DNA analysis for rapid detection of actionable mutations to select metastatic colorectal patients for anti-EGFR treatment. Ann Oncol, 2017, 28(3): 214-219.
[17] Mithraprabhu S, Hocking J, Ramachandran M, et al. Circulating tumor DNA: a promising biomarker in multiple myeloma. Blood Cancer J, 2017, 7(5): e548.
[18] Li Guangyu, Wu Tianwen, Peng Hanhua, et al. A Study on the Diagnostic Value of Magnetic Resonance Imaging in Multiple Myeloma. Shenzhen Journal of Integrated Traditional and Western Medicine, 2017, 27(02): 41-42.
[19] Messiou C, Porta N, Sharma B, et al. Prospective evaluation of whole-body MRI versus FDG PET/CT for lesion detection in participants with myeloma. Radiology: Imaging Cancer, 2021, 3(5): e210048.
[20] Zheng C, Qu Y, Qin X, et al. Artificial intelligence in the diagnosis and prognosis of multiple myeloma. Frontiers in oncology, 2018, 8: 512.
[21] Reeder C B, Reece D E, Kukreti V, et al. Applications of artificial intelligence in multiple myeloma. Expert review of anticancer therapy, 2018, 18(2): 181-188.
[22] Zhang Q, Huang L, Ding Y. Application of machine learning in diagnosis and treatment of multiple myeloma. Frontiers in oncology, 2011, 11: 648223.
[23] Sonneveld P, Avet-Loiseau H, Lonial S, et al. Treatment of multiple myeloma with high-risk cytogenetics: a consensus of the International Myeloma Working Group. Blood, 2016, 127(24): 2955-2962.
[24] Abramson H N. Immunotherapy of Multiple Myeloma: Promise and Challenges. ImmunoTargets and Therapy, 2021: 343-371.
[25] Mateos MV, Orlowski RZ, Ocio EM. Immunotherapy in multiple myeloma: Recent advances and future directions. Leukemia, 2021, 35(6): 1620-1632.
[26] Palumbo A, Chanan-Khan A, Weisel K, et al. Daratumumab, bortezomib, and dexamethasone for multiple myeloma. New England Journal of Medicine, 2016, 375(8): 754-766.
[27] Wang Jun, Liu Aichun. Advances in immunotherapy research for multiple myeloma. Modern Oncology Medicine, 2022, 30(12): 2263-2267.