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多发性骨髓瘤(MM)的中位生存期为2-3年,对化疗无反应且疾病进展的患者仅生存几个月,而“冒烟性”多发性骨髓瘤(SMM)可生存许多年。 SMM的诊断取决于血清内M-蛋白>3g/dl及骨髓内浆细胞>10%,但无贫血,肾功能不全或骨损害,尿中常发现少量M-蛋白,骨髓活检标本中常见到浆细胞成簇或聚集,浆细胞的标记指数(LI)是低的。一些MM病人的症状多年没有发展,识别这些病人有重要意义,因为病情无进展不需治疗,而符合MM诊断标准的大多数病人有症状且应该治疗。SMM是有一段“良性”单克隆丙种球蛋白病(意义未明的单克隆丙种球蛋白病,MGUS)阶段,当M蛋白>3g/dl及骨髓浆细胞>10%之前,SMM难于确诊。目前通用的临床分期标准是根据与骨髓瘤细胞总数有关的多项临床表现来制定的。瘤细胞总数高
The median survival of multiple myeloma (MM) is 2-3 years, with patients who do not respond to chemotherapy and progression of disease survive for only a few months while “smoky” multiple myeloma (SMM) can survive for many years . The diagnosis of SMM depends on the serum M-protein> 3g / dl and bone marrow pulp cells> 10%, but no anemia, renal insufficiency or bone damage, often found in urine M-protein, bone marrow biopsy specimens common to plasma cells Clustered or aggregated, the plasma cell labeling index (LI) is low. The symptoms of some MM patients have not progressed for many years and the identification of these patients is important because no progression is required and no treatment is required and most patients who meet the criteria for MM diagnosis have symptoms and should be treated. SMM has a stage of “benign” monoclonal gammopathy (monoclonal gammopathy of unknown significance, MGUS) that is difficult to diagnose until M protein> 3g / dl and bone marrow plasma cells> 10%. The current general clinical staging criteria are based on a number of clinical manifestations related to the total number of myeloma cells. Tumor cells in total high