ZNAČAJ ODREĐIVANJA PROGNOSTIČKOG PROFILA U LEČENJU BOLESNIKA SA MULTIPLIM MIJELOMOM

  • Marko Mitrovic Klinika za Hematologiju, KCS
  • Aleksandra Sretenović Klinika za hematologiju KCS
  • Jelena Bila
Ključne reči: Multipli mijelom, prognostički profil

Sažetak


Multipli mijelom (MM) predstavlja hematološku neoplaziju koja se karakteriše klonskom ekspanzijom najzrelijih B-limfocita, odnosno plazmocita (Plc), u kostnoj srži (KS). Zahvaljujući novim modalitetima lečenja petogodišnje preživljavanje obolelih od MM u značajnoj meri je poboljšano u poslednjih 15-tak godina, tako da danas iznosi 60-70%. Od presudne je važnosti za svakog obolelog odrediti individualni prognostički profil koji se bazira na: Biološkim karakteristikama bolesti; Kliničkim karakteristikama bolesnika; i Karakteristikama terapijskog odgovora. Biološke karakteristike bolesti su definisane kliničkim stadijumom prema Durie-Salmon klasifikaciji, i prognostičkim indeksima, internacionalnim “staging system” skorom (ISS) i revidiranim ISS (R-ISS) skorom. Metodama molekularne genetike kao što je sledeća generacija sekvencioniranja (NGS) otkrivene su brojne genske mutacije od prognostičkog značaja. Od kliničkih karakteristika bolesnika, ističu se godine života i komorbiditetni status obolelog jer su od ključne važnosti za terapijski izbor i podobnost za lečenje visokodoznom hemioterapijom sa autologom potporom matične ćelije. Na prognozu bolesti veliki uticaj ima i karakteristika terapijskog odgovora, tj postizanje kompletne remisije (CR) nakon inicijalnog lečenja i negativnost minimalne rezidualne bolesti (MRD).

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2020/12/31
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