2013年 · 第52卷第09期

multiple myeloma (MM) is a malignant proliferative disease of plasma cells characterized by abnormal proliferation of clonal plasma cells in the bone marrow, secretion of monoclonal immunoglobulin or its fragment (M protein), and resulting in damage to related organs or tissues. The common clinical manifestations are bone pain, anemia, renal insufficiency and infection.

Compared with the 2011 edition, the Guidelines for the Diagnosis and Treatment of Multiple Myeloma in China (revised in 2013) (hereinafter referred to as the Guidelines) has made great changes in the diagnosis part. Not only have new concepts and new standards been introduced, but also new technologies such as necessary testing items and testing items that are valuable for diagnosis and prognosis have been introduced, striving to not only be based on China's national conditions, but also keep up with the international frontier, so as to make the diagnosis of multiple myeloma more comprehensive, detailed and rigorous.

The Guidelines for the Diagnosis and Treatment of Multiple Myeloma (MM) in China (hereinafter referred to as the Guidelines) has been revised for the third time. Compared with the 2011 edition, this revision has made great changes. The author makes an interpretation of the treatment part, in order to help clinicians in the choice of treatment options.

The efficacy criteria of the Guidelines for the Diagnosis and Treatment of Multiple Myeloma in China (Revised in 2013) (hereinafter referred to as the Guidelines) are formulated with reference to the efficacy criteria of the European Bone Marrow Transplant Collaborative Group (EBMT) in 1998 and the International Myeloma Working Group (IMWG) in 2006. EBMT standard is more widely used in the world, while IMWG standard is based on EBMT with some modifications and supplements. The efficacy criteria section of this guideline is now interpreted for better understanding and application.

asymptomatic multiple myeloma (AMM), also known as smoldering multiple myeloma (SMM), is similar to monoclonal immunoglobulinemia (MGUS) of unknown significance, which is considered an early stage in the development of MM, whereas SMM is a stage between MGUS and multiple myeloma (MM). The incidence of progression to symptomatic MM in MGUS is approximately 1% each year, while the probability of progression to MM in SMM decreases year by year, from 10% in the first 5 years after diagnosis, to 3% in the second 5 years, and to 1% in the following 10 years^[1]。 With the progress of MM research, the current understanding of SMM is deeper.