Клиническая онкология: отчеты о случаях заболевания

Multiple Myeloma: A Comprehensive Overview of Pathogenesis, Diagnosis, and Treatment Strategies

Alan Walker

Multiple Myeloma (MM) is a hematological malignancy characterized by the uncontrolled proliferation of plasma cells within the bone marrow. This review provides a comprehensive examination of the pathogenesis, clinical manifestations, diagnostic modalities, and contemporary treatment approaches associated with multiple myeloma. The pathogenesis of MM involves clonal expansion of plasma cells, leading to the production of monoclonal proteins and interference with normal hematopoiesis. Genetic abnormalities, including chromosomal translocations and mutations, play a crucial role in the initiation and progression of the disease. The aberrant plasma cells induce bone destruction, resulting in skeletal complications such as fractures and pain. Diagnosis of MM relies on a combination of laboratory tests, including serum and urine protein electrophoresis, immunofixation, and bone marrow biopsy. Imaging studies, such as X-rays and magnetic resonance imaging (MRI), aid in assessing bone involvement and staging the disease. Precise diagnostic criteria, including the presence of specific clinical symptoms and laboratory findings, facilitate accurate identification and classification of the disease.Treatment strategies for MM have evolved significantly, with a range of therapeutic options available. Conventional chemotherapy, immunomodulatory drugs, and proteasome inhibitors form the backbone of initial treatment. Autologous stem cell transplantation is considered in eligible patients, and targeted therapies, such as monoclonal antibodies and immune checkpoint inhibitors, have shown promising results. Supportive care measures, including bisphosphonates for bone health and management of treatment-related complications, are integral components of the multidisciplinary approach to patient care. Despite advancements in therapy, MM remains a challenging disease with variable outcomes. Prognostic factors, including cytogenetic abnormalities and response to initial treatment, guide risk stratification and influence subsequent therapeutic decisions. Ongoing research endeavors focus on unraveling the molecular complexities of MM, paving the way for innovative treatments and personalized medicine approaches.