| 丁江华.多发性骨髓瘤相关性感染的防治现状[J].安徽医药,2023,27(5):1037-1040. |
| 多发性骨髓瘤相关性感染的防治现状 |
| Current prevention and treatment for multiple myeloma-related infections |
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| DOI：10.3969/j.issn.1009-6469.2023.05.043 |
| 中文关键词: 多发性骨髓瘤 感染 抗生素预防 |
| 英文关键词: Multiple myeloma Infection Antibiotic prophylaxis |
| 基金项目:江西省卫生健康委科技计划项目( 20204282) |
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| 中文摘要: |
| 骨髓瘤相关性感染( MRIs)直接影响多发性骨髓瘤( MM)病人生存与预后，是 MM的首位并发症与死因，其主要机制为 MM内在性免疫缺陷与治疗相关性免疫抑制两方面。 MRIs发生贯穿于 MM诱导、维持及挽救治疗等不同阶段，定期检测降钙素原( PCT)、 C反应蛋白( CRP)、肿瘤坏死因子( TNF-α)等炎症指标及胸部 CT检查有助于早期判断 MRIs发生及程度。 MRIs以细菌感染与肺部感染最常见，又以治疗初 2月内发生率最高。预防性抗生素治疗仅应用于发生严重感染及中性粒细胞减少性发热的高危 MM人群，而预防性抗病毒治疗主要用于接受自体干细胞移植与硼替佐米治疗的 MM病人。粒细胞集落刺激因子(G-CSF)尤其是长效 G-CSF制剂在预防 MRIs发生具有肯定疗效，可作为 MRIs的主要方法。 |
| 英文摘要: |
| Myeloma-related infections (MRIs) directly affect the survival and prognosis of patients with multiple myeloma (MM), oc-cupying the first complication and cause of death of MM. The main mechanisms of MRIs are ascribed to intrinsic immune dysfunctionand therapy-related immunosuppression. MRIs run through the total course including induction, maintenance and salvage treatments.Regular testing procalcitonin (PCT), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and chest computer tomography (CT)contribute to early judgement of MRIs' occurrence as well as its degree. Bacterial and lung infections are the most common type ofMRIs, which has the highest incidence within the initial 2 months of treatment. Prophylactic antibiotics use has been only approved forthose high-risk MM patients with tendency to severe infection and febrile neutropenia. Prophylactic anti-virus agents have been mainly recommended for MM patients treated by autologous stem cell transplantation and bortezomib-base regimens. Granulocyte-colony stim-ulating factor (G-CSF), especially long-acting G-CSF preparations, has a positive effect in preventing the occurrence of MRIs and can be used as the main method for MRIs. |
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