Past, Present, and Future of Dexamethasone in Multiple Myeloma and AL Amyloidosis.

Dexamethasone doses of approximately 40 milligrams (mg) once weekly are often continued for months or years despite accumulating evidence that they can cause dose-dependent toxicities such as cataracts and infections.

尽管有越来越多的证据表明，每周约40毫克的地塞米松剂量可能会引起剂量依赖性的毒性，如白内障和感染，但这种剂量通常会持续数月甚至数年。

Acute dexamethasone-related toxicities such as insomnia or pedal edema, even if low-grade by clinical criteria, can significantly interfere with patient quality of life.

急性地塞米松相关的毒性反应，如失眠或下肢水肿，即使按照临床标准为低级别，也可能显著干扰患者的生活质量。

In the past 5 years, several trials have demonstrated the efficacy and improved tolerability of corticosteroid-sparing regimens in MM.

在过去的5年中，几项试验已经证明了在多发性骨髓瘤中使用减少皮质类固醇剂量的方案的有效性和改善的耐受性。

In this review, we discuss these and other studies to comprehensively assess the role of dexamethasone in the modern era.

在这篇综述中，我们讨论了这些以及其他研究，全面评估了地塞米松在现代医学中的作用。

In newly diagnosed MM, robust data support planned dexamethasone discontinuation after one to two cycles in older and frailer patients.

在新诊断的多发性骨髓瘤中，充分的数据支持在老年和体弱患者中计划在一到两个周期后停用地塞米松。

In the maintenance setting, the risk-benefit ratio of prolonged dexamethasone is unfavorable.

在维持治疗中，长期使用地塞米松的风险-效益比是不利的。

While randomized trials have shown that once-weekly dexamethasone adds value within doublet regimens in relapsed/refractory MM, its contribution to triplet and quadruplet regimens is uncertain.

虽然随机试验表明，每周一次的地塞米松在复发/难治性多发性骨髓瘤的双重方案中增加了价值，但其对三重和四重方案的贡献尚不确定。

Furthermore, data suggest that indefinite dexamethasone may actually limit the feasibility and efficacy of subsequent postprogression therapies.

此外，数据表明，无限制地使用地塞米松实际上可能会限制后续疾病进展后治疗的可行性和效果。

In AL amyloidosis, dexamethasone 40 mg once weekly for 6 months is excessive and may predispose patients to volume overload.

在AL淀粉样变性中，每周一次40毫克地塞米松连续使用6个月是过度的，可能会使患者容易出现容量超负荷。

In our review, we also discuss dexamethasone as a premedication for CD38-targeted monoclonal antibodies (where it is no longer required after one to two cycles) and for supportive care (where lower doses of 4-8 mg as needed can often suffice).

在我们的回顾中，我们还讨论了地塞米松作为CD38靶向单克隆抗体的预处理药物（在1至2个周期后不再需要），以及作为支持性护理（通常需要时4-8毫克的较低剂量就足够了）。

Despite the historical inertia of corticosteroid-containing regimens in clinical trials and practice guidelines, corticosteroid-sparing regimens warrant prospective investigation across the gamut of plasma cell disorders.

尽管在临床试验和实践指南中，含皮质类固醇的方案存在历史惯性，但在各种浆细胞疾病中，减少皮质类固醇的方案值得前瞻性研究。