()






owner-imfjapan@myeloma.gr.jp
http://www.myeloma.gr.jp/
03-3260-3970

---

I.






















10





1

---

II.


















III. 5

2

---

1
2

3
4
5




4000
15-20% 1%

1
4
3 2

55






()



3

---

DNA



5% 30%
90%
()


(%)










4

---

IL-1, IL-6 TNF ()

3

()

















5

---

2












10% 30%





90-100%


30%

(i)
(ii)



MRI FDG/PET

6

---

MGUS


?




3












MGUS
10% 20%



MGUS
MGUS 2
10 MGUS
7

---

3
MGUS

(Indolent myeloma)
MGUS



(Smoldering myeloma)
MGUS







4
(i)
(ii) ()
(iii)
(iv)
1(Stage I;) 3(Stage III;)
A()B()

Stage I A
Stage III B
8

---

?


()


2


11 13 14
5 7






IgG : (
IgA :
:

IgD :
IgM :
IgE :

9

---

IgG

3



















10

---

(


)




pamidronate )



QOL
Erythropoietin























4

A










11

---

MP








VAD





VCAP





12

---

CP MVP CVP MCNU-VMP EDAP

B.









C.
BMTPBSCT



()






HLA
13

---

:


( VAD )



(HLA
)







D





(I)



3

(II)()
14

---

3




(III)



(


)
(QOL)
(
)
(IV)





E.


(I)




15

---

(II)

(III)

()
(IV)


(V)





5.









16

---

17

---

18

---

IV.
19

---

IgG, IgA ():
A
H ()
H L (
) 5 IgG H
L IgG IgG
L ()
()



IgD, IgE() :
IgG IgA







DNA


6090mg 500cc




20

---

HLA

HLA


PBSCT
Syngeneic







MRI()





()
()

(
) 1

21

---

MDR()


P-

P-
PSC833


Procrit














D


22

---

CAT










()

()









150,000 250,000 50,000
10,000
23

---

Aredia









/







JAMSHIDI
24

---

()













DEXA







25

---

GCSF


CR (Complete Remission)






PR PR (Partial Remission) CR
SWOG ( South Western Oncology Group) 50 75
50

26

---

`'



50
CR PR








g/dl 13g/dl14g/dl









10


90

27

---

M
24
0.1 / 24














IgG, IgA,,









28

---

LDH
CRP




MRI CT
MIBI PET

24
29

---