Новые подходы в диагностике и терапии множественной миеломы (обзор литературы)

Множественная миелома – злокачественное новообразование, вызванное неконтролируемой пролиферацией опухолевых плазматических клеток. С внедрением новых препаратов и методов лечения в последнее десятилетие увеличилась глубина ответа и общая выживаемость пациентов с ММ. Однако ММ остается неизлечимым заболеванием с развитием рецидивов или рефрактерности к лечению. Поэтому поиск факторов прогноза является постоянной темой изучения многих исследований. Благодаря применению современных технологий в диагностике появилась возможность уже на начальном этапе выявлять группу пациентов с высоким риском прогрессии. Это позволяет разрабатывать новые стратегии в лечении. В данном обзоре представлены новые достижения в диагностике и лечении ММ.

1. Palumbo, A. Multiple myeloma / A. Palumbo, K.N. Anderson // Engl J Med. – 2011. – Т. 1046. – P. 10.

2. New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells / E. Pérez-Persona [et al.] // Blood, The Journal of the American Society of Hematology. – 2007. – Т. 110. – №. 7. – P. 2586-2592.

3. Durie, B.G.M. A clinical staging system for multiple myeloma correlation of measured myeloma cell mass with presenting clinical features, response to treatment, and survival / B.G.M. Durie, S.E. Salmon // Cancer. – 1975. – Т. 36. – №. 3. – P. 842-854.

4. International staging system for multiple myeloma / P.R. Greipp [et al.] // Journal of clinical oncology. – 2005. – Т. 23. – №. 15. – P. 3412-3420.

5. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma / S.V. Rajkumar [et al.] // The lancet oncology. – 2014. – Т. 15. – №. 12. – P. e538-e548.

6. Rajkumar, S.V. Multiple myeloma: 2016 update on diagnosis, risk‐stratification, and management / S.V. Rajkumar // American journal of hematology. – 2016. – Т. 91. – №. 7. – P. 719-734.

7. Flow cytometric disease monitoring in multiple myeloma: the relationship between normal and neoplastic plasma cells predicts outcome after transplantation / A.C. Rawstron [et al.] // Blood, The Journal of the American Society of Hematology. – 2002. – Т. 100. – №. 9. – P. 3095-3100.

8. Multiparameter immunophenotyping by flow cytometry in multiple myeloma: The diagnostic utility of defining ranges of normal antigenic expression in comparison to histology / E. Cannizzo [et al.] //Cytometry Part B: Clinical Cytometry. – 2010. – Т. 78, №4. – P. 231-238.

9. Report of the European Myeloma Network on multiparametric flow cytometry in multiple myeloma and related disorders / A.C. Rawstron [et al.] // Haematologica. – 2008. – Т. 93, №3. – P. 431-438.

10. Reference values to assess hemodilution and warn of potential false-negative minimal residual disease results in myeloma / N. Puig [et al.] // Cancers. – 2021. – Т. 13, №19. – P. 4924.

11. VS38c and CD38-multiepitope antibodies provide highly comparable minimal residual disease data in patients with multiple myeloma / A. Broijl [et al.] // American Journal of Clinical Pathology. – 2022. – Т. 157, №4. – P. 494-497.

12. CD319 (SLAMF7) an alternative marker for detecting plasma cells in the presence of daratumumab or elotuzumab / K.T. Soh [et al.] //Cytometry Part B: Clinical Cytometry. – 2021. – Т. 100, №4. – P. 497-508.

13. Standardization of flow cytometric minimal residual disease assessment in international clinical trials. A feasibility study from the European Myeloma Network / D.H. Bruinink [et al.] // Haematologica. – 2021. – Т. 106, №5. – P. 1496.

14. Immunophenotype of normal vs. myeloma plasma cells: Toward antibody panel specifications for MRD detection in multiple myeloma / J. Flores‐Montero [et al.] // Cytometry Part B: Clinical Cytometry. – 2016. – Т. 90, №1. – P. 61-72.

15. Chromosomal abnormalities are major prognostic factors in elderly patients with multiple myeloma: the intergroupe francophone du myélome experience / H. Avet-Loiseau [et al.] // Journal of clinical oncology. – 2013. – Т. 31, №22. – P. 2806.

16. Hanamura, I. Multiple myeloma with highrisk cytogenetics and its treatment approach / I. Hanamura // International Journal of Hematology. – 2022. – Т. 115, №6. – P. 762-777.

17. A. Dhabe, Role of Conventional Cytogenetics and FISH in the Laboratory Work Up of Plasma Cell Dyscrasias / A. Dhabe, S. Das, M. Parihar // Indian Journal of Medical and Paediatric Oncology. – 2023.

18. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma / S. Kumar [et al.] // The lancet oncology. – 2016. – Т. 17, №8. – P. e328-e346.

19. Multiparametric flow cytometry for MRD monitoring in hematologic malignancies: clinical applications and new challenges / G. Riva [et al.] //Cancers. – 2021. – Т. 13, №18. – P. 4582.

20. Immunophenotype of normal vs. myeloma plasma cells: Toward antibody panel specifications for MRD detection in multiple myeloma / J. Flores‐Montero [et al.] // Cytometry Part B: Clinical Cytometry. – 2016. – Т. 90, №1. – P. 61-72.

21. Minimal residual disease in multiple myeloma: State of the art and applications in clinical practice /A. Gozzetti [et al.] //Journal of Personalized Medicine. – 2020. – Т. 10, №3. – P. 120.

22. Multiparameter flow cytometric remission is the most relevant prognostic factor for multiple myeloma patients who undergo autologous stem cell transplantation / B. Paiva [et al.] // Blood. – 2008. – Vol. 112(10). – P. 4017-4023. https://doi.org/10.1182/blood-2008-05-159624.

23. Reuter, J.A. High-throughput sequencing technologies / J.A. Reuter, D.V. Spacek, M.P. Snyder // Molecular cell. – 2015. – Т. 58, №4. – P. 586-597. doi: 10.1016/j.molcel.2015.05.004

24. NGS-based molecular karyotyping of multiple myeloma: results from the GEM12 clinical trial / J.M. Rosa-Rosa [et al.] // Cancers. – 2022. – Т. 14, №20. – P. 5169. doi: 10.3390/cancers14205169

25. Exploratory trial of a biepitopic CAR T-targeting B cell maturation antigen in relapsed/refractory multiple myeloma / J. Xu [et al.] // Proceedings of the National Academy of Sciences. – 2019. – Т. 116, №19. – P. 9543-9551. doi: 10.1073/pnas.1819745116.

26. A phase 1 study of a novel fully human BCMA-targeting CAR (CT103A) in patients with relapsed/ refractory multiple myeloma / D. Wang [et al.] // Blood, The Journal of the American Society of Hematology. – 2021. – Т. 137, №21. – P. 2890-2901. doi: 10.1182/blood.2020008936