A myeloma multiplex diagnosztikája és kezelése terén jelentős előrelépések történtek az elmúlt évek során. Az immunmoduláns ágensek, a proteaszómagátlók és a nagy dózisú melfalánnal való kondicionálást követő autológ haemopoeticus őssejt-transzplantáció bevezetése lehetővé tette a mélyebb terápiás válasz és a hosszabb távú túlélés elérését. Ennek ellenére a szakirodalom továbbra is a betegség gyógyíthatatlanságát hangsúlyozza, mivel a remissziók és a relapsusok váltakozása továbbra is meghatározza a kórkép lefolyását. A myeloma multiplex esetében a definitív gyógyuláshoz elengedhetetlen a gyógyszer-rezisztencia leküzdése és a tartós válasz biztosítása. Ennek eléréséhez új terápiás stratégiák kidolgozására és érzékenyebb diagnosztikus eszköztárra van szükség. Közleményünk célja a jelenleg alkalmazott kezelési irányelvek áttekintése mellett az új diagnosztikus eljárások és a klinikai vizsgálatokban szereplő terápiás stratégiák összefoglalása, melyek javíthatják a betegek életminőségét és túlélési esélyeit. A modern diagnosztikus módszerek lehetővé teszik a betegség korai felismerését, a személyre szabott, biológiai alapú kezelések bevezetését és a válaszadaptált terápia alkalmazását. Továbbá az immunterápiás stratégiák korábbi kezelési vonalakba való beépülése a jövőben megkérdőjelezheti a betegség gyógyíthatatlanságáról kialakított elképzeléseket. Orv Hetil. 2024; 165(23): 891–899.
Significant advances have been made in the diagnosis and treatment of multiple myeloma in recent years. The introduction of immunomodulatory drugs, proteasome inhibitors and autologous hematopoietic stem cell transplantation after high-dose melphalan conditioning have allowed for a more profound therapeutic response and longer-term survival. Despite this progress, the literature still emphasizes the incurability of the disease, since the alternation of remissions and relapses continues to determine the course of disease. In multiple myeloma, it is essential to overcome drug resistance and ensure durable response to achieve a definitive cure, therefore new therapeutic strategies and a more sensitive diagnostic tool are needed. In addition to reviewing current treatment guidelines, this publication aims to provide a summary of new diagnostic procedures and therapeutic strategies in clinical trials that can improve patients’ quality of life and survival. Modern diagnostic methods enable early disease detection, personalized biologically-based treatments, and response-adapted therapy. Additionally, integrating immunotherapeutic strategies into earlier lines of treatment may challenge perceptions of the disease’s incurability in the future. Orv Hetil. 2024; 165(23): 891–899.
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