【摘要】 多发性骨髓瘤是恶性浆细胞病中最常见的一种类型,又称骨髓瘤、浆细胞骨髓瘤。多发性骨髓瘤的特征是单克隆浆细胞恶性增殖分泌大量的单克隆免疫球蛋白,导致正常多克隆浆细胞及多克隆免疫球蛋白分泌受到抑制。随着硼替佐米、雷利度胺的广泛应用,多发性骨髓瘤的治疗效果极大提升。但是有学者发现多发性骨髓瘤出现新的生物学行为,如:M蛋白的转变、髓外复发等,称之为克隆演变。本文报道1例在治疗过程中发生克隆演变的多发性骨髓瘤患者的临床特征、实验室检查、治疗经过、克隆演变特点及预后,同时结合相关文献进行讨论。更多还原

【Abstract】 Multiple myeloma( MM) is one of the most common malignant plasma cell diseases,also called myeloma or plasma cell myeloma.MM is characterized by monoclonal plasma cells malignantly proliferating and secreting plenty of monoclonal immunoglobulin which leads to the inhibition of normal polyclonal plasma cells and polyclonal immunoglobulin secretion.With bortezomib and lenalidomide widely used,curative effect on MM has been improved a lot.Some new biological behavior shave been found by some scholars,such as the change of M protein and extramedullary recurrence,which are called clonal evolution in MM patients.This paper reported one case of MM patient with clonal evolution.Clinical features,laboratory,treatment,clonal evolution characteristics,and prognosis were discussed in combination with literature review.更多还原