1.................................................................................................................
2..................................................................................?
4.................................................
5.............................................................
6...................................?
8............................................................
10.....................................................(Staging)
12........................................................................................
15........................................................................
16......................
19..................................................................................................
21....................................
21...............................................
24.........................................................................................
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www.myeloma.org :
.(800) 452-CURE :
.
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,
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.
.
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()
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melphalan
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Alkylating
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Allogeneic
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-
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,
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Analgesic
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g/dL 13-14
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.
,
24
.
,
Anesthesia
.
.
Angiogenesis
.
,
Angiogenesis Inhibitors
.
.
Antibiotics
(
)
Antibody
.
, ,
.
.
.
,
.
.
.
Antiemetic Drug
.
Antifungal Agent
(
,
)
Antigen
.
,
Antineoplastic Agent
.
(
)"
Appendicular Skeleton
.
,
,
Apoptosis
.
25
.
, .
,
Aspiration
indolent,
.
Asymptomatic Myeloma
.
smoldering
.
, Axial Skeleton
,
B Cells
.B
.
.
.
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-
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Bence Jones
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.
Beta 2 Microglobulin (ß2M)
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10%-
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/
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ß2M
.
ß2M
90%- , .
.
Biopsy
.
,
Bisphosphonate
.(
)
(
)
26
,
.
Blood Cells
.
,
Blood Count
.
Bone Marrow
.
,
,
,
Bone Marrow Aspiration
.
,
,
Bone Marrow Biopsy
.
.
.
,
.
,)
Bone Remodeling
(
)
(
.
BUN (Blood Urea Nitrogen)
.
BUN .
.BUN
,
,
, Calcium
.hydroxyapatite-
.
Cancer
.
27
.
Carcinogen
CAT (Computerized Axial Tomography) scan
,
CT
.
.(Computerized Tomography)
, Catheter
(CVC)
.
,
.
.
,
.
Cell
)
- Cell Differentiation
()
(
.
Cell Proliferation
.
Chemotherapy
.
,
Combination Chemotherapy ·
.
.
"
Chromosome
46
,
.
.
.
Chronic
28
.
Clinical
.
Clinical Trial
.
, ,
Control Group ·
.
.
;
End Point ·
.
,
Experimental Group ·
.
Randomized Clinical Trial ·
.
(
)
MDT-
Phase I Trial ·
.
I
,
.
.
I;
3-6
(cohorts)
I
,
.
.
,
,
,
.(DLT - dose limiting toxicity)
.II
.
II
Phase II Trial ·
14-50 ,
.I
29
.
,
,
.III
,
II
.
,
.II
III
,
.III
Phase III Trial ·
.
(stage)
,
III
.
III
.
III
.
50
III
.
,
II
III
.
.
.
Creatinine
,
.
.
.
Cyst
Cytokine
,
)
.
.
(
DEXA (Dual Photon X-ray Absorptionmetry) study
.
.
Dexamethasone
.
30
.
Diagnosis
,
Dialysis
.
Disease Free Survival
.
DLT (Dose Limiting Toxicity)
.
;
DNA
.
.
Drug Resistance
.
.
. , Edema
"efficacy"
,
.
Efficacy
.
()
Electrophoresis
,
.
(M
)
.
.
.
Enzyme
.(RBC)
,
Erythrocytes
.
,
31
.
- Erythropoietin
.
.
.
,
.
,
,
,
Free Light Chains
.Freelite test-
,
,
."
"
Gene
,
.
,
.
.
Gene Therapy
,
.
,
.
.
"
, Genetic
Graft-versus-host disease (GVHD)
.
, .
Granulocyte
.
.
Hematocrit (Hct)
.
.
Hematologic
.
Hematologist
32
,
Herpes Simplex
."cold sores"
,
,
Herpes Zoster
.
.
Hormones
.
Human leukocyte antigen (HLA) test
.
.
Hypercalcemia
,
, , , ,
,
.
,
.
,
.
,
.
A- G .
- IgG, IgA
,
,
.
, .
,
( G
)
IgG-
IgG
)"
.
.(
,
.
.
'
-
,
.
IgD, IgE
33
.Waldenstrom's macroglobulinemia-
IgM
.
Immune System
.
, ,
.
, Immunodeficiency
.
Immunofixation
M (IgG,-
,
.
immunostaining
.(
,IgA
.(M
)
,
Immunoglobulin (Ig)
.
()
.
.IgA, IgG, IgM, IgD, IgE
Immunosuppression
,
.
,
.
.
Immunotherapy
.
.
Incidence
Induction Therapy
.
.
Informed Consent
,
, ,
.
.
,
,
34
.
.
Infusion
Infusion Pump
.
.
,
.
Inhibit
.
.
Injection
()
Interferon
.
(
)
""
,
.
,
,
Interleukin
.(
)
,
(IL-2) 2
.
(IL-6) 6
.
.
.
,
LDH
()
.
, Lesion
-
Lesion
, .
.
.
.
, Leukocytes
.(WBC)
.
Leukopenia
35
.
Lymphocytes
.
Lytic Lesions
.
,
.
M proteins (M spike)
M spike
.
.M
.
.
Maintenance Therapy
.
.
, Malignant
.
,
MDR (Multi Drug Resistance)
.
,vincristine- adriamycin-
.
p-glycoprotein
.
.
Melanoma
.
,
.
,
Metastasize
,
.()
.
,
( ,
)
36
MGUS (Monoclonal Gammopathy of Undetermined Significance)
.
M
,
,
Molecule
.
.
Monoclonal
,
,
.()
.()
.
(M spike)
.
Monoclonal Antibodies
.
,
.
.
, Monocyte
MRI (Magnetic Resonance Imaging)
,
,
,
MRI .
.
MTD (Maximum Tolerated Dose)
.
Myelodysplastic Syndrome
.
.
.myelogenous
.
,
Myeloid
.
37
,
Myelosuppression
.
.
,
,
Neoplasia
,
.
Neoplasm
.
(
)
.
Neutropenia
,
.
.
,
.(®Neupogen
)
G-CSF
.
, Neutrophils
,
. Oncogene
(
)
.
,
.
.
, Oncologist
.
, Osteoblast
. ,
,
,
Osteoclast
.
,
. (
)
.
.
, Osteoid
38
,
Osteonecrosis of the jaws
.
,
,
.
Osteoporosis
.
.
.
Palliative Treatment
,
.
.
Pathological Fracture
,
.
,
Pathology
.
.
PET (Positron Emission Tomography) scan
PET
.
.
(
)
.
, Placebo
.
,
,
Plasma
.
.
.
Plasma cells
.
.
.
,
.M
,
.(
,
)"
39
.
-
Plasmacytoma
.
,
-
.
Plasmapheresis
.
.
.
Platelet
.
.
.
.
Port-Implanted
, .
,
.
.
,
.
.
Prognosis
.
.
Progression Free Survival
,
,
.
.
.
Progressive disease
,
Protocol
.
,
,
.
Precancerous
.
,
Radiation Therapy
(external radiation)
.
.(implant radiation)
40
.
,
Radiologist
.
,
,
.
Recurrence
,
,
Red Blood Cells (Erythrocytes)
.
.
()
.
.
,
.
,
.
.
Refractory
.
Regression
Relapse
.
Remission, Response
.
.
/
M
CR ,
Complete Remission (CR) ·
/
;
;
.
CR .
,
PR ,
Partial Remission (PR) ·
.50-75%
PR
,SWOG
.CR
.50%
PR
41
RNA (ribonucleic acid)
RNA .
RNA-
R.NA (deoxy-ribonucleic acid). RNA
.
Serum Osteocalcin
.
.
.
.Herpes Zoster
,
Shingles
.
.
Side Effects
,
,
,
.
.
Skeletal Survey (metastatic survey)
/
, ,
,
.
,
Stable Disease
.
50%-
.
(PR
CR-
) -
.
,
.
Stage
.
Staging
.
.
Stem Cells
.
,
,
.
42
.
,
Steroid
.
,
.
Supportive Care
.
Systemic Therapy
.
.Platelets
, Thrombocytes
450,000 - 150,000
.
Thrombocytopenia
.
50,000-
.10,000-
,
TNF (Tumor Necrosis Factor)
.
.
,
.
Toxins
.
Transfusion
,
Transplantation
.
/
.
.
Bone Marrow Transplantation ·
.
.
,
,
Peripheral blood stem cell transplantation ·
,
(
)
.
.
43
.()
()
Allogeneic ·
.
,
Autologous ·
.
,
Matched unrelated donor transplants (MUDs) ·
,
,
.
.
.
Syngeneic ·
.
.
Tumor
.
.
Tumor Marker
.
, (
)
.
Vaccine
,
.
.
.
, Virus
.
.
Waldenstrom's macroglobulinemia
.
. IgM
.
White Blood Cells (WBCs)
.
,
.
.
, ,
.
X ray
.
,
44
"IMF
.... "
.(IMF)
-
"
56514
, 2020 ..
03-7360085 .
Email: info@amen.org.il
.
© 2004 International Myeloma Foundation
45