摘要
目的观察来那度胺联合小剂量地塞米松(Rd)治疗老年多发性骨髓瘤的疗效及安全性。方法回顾性收集2013年6月至2017年6月首都医科大学附属北京朝阳医院西院血液科收治的老年骨髓瘤患者共36例,其中男性23例(63.9%),女性13例(36.1%),年龄(72.0±2.4)岁,均给予Rd方案治疗,具体为:来那度胺25 mg/qod或者10 mg/qd,d1~21,地塞米松10~20 mg/w,28 d为1个疗程。采用国际骨髓瘤工作组(IMWG)标准评价治疗效果,按照国际肿瘤组织毒副作用统一命名法的标准(NCICTCAE第3版)判断不良反应。结果 36例患者获得满意随访,随访率100%,随访时间1~48个月,平均(20±3)个月。末次随访时,1例(2.7%)达到完全缓解,10例(27.8%)非常好的部分缓解,13例(36.1%)部分缓解,6例(16.7%)疾病稳定,4例(11.1%)疾病进展,2例(5.6%)死亡,总有效率为66.6%。不良反应主要为乏力及骨髓抑制。结论来那度胺联合小剂量地塞米松治疗老年多发性骨髓瘤患者,疗效好,患者耐受性好,可作为老年多发性骨髓瘤患者的推荐治疗方案。
Objective To evaluate the efficacy and safety of lenalidomide plus low-dose dexamethasone in the treatment of elderly multiple myeloma(MM) patients. Methods The clinical records of 36 elderly MM patients were analyzed including 23 males(63.9%) and 13 females(36.1%). The average age was72.0±2.4 years and all patients were treated with lenalidomide plus low-dose dexamethasone(lenalidomide25 mg/qod or 10 mg/qd on day 1-21 of each 28-day cycle,dexamethasone 10-20 mg per week). Adverse reaction and therapeutic efficacy was determined by NCICTCAE(3 rdedition) and IMWG. Results There were36 patients well followed-up with an average of 20±3 months, range of 1-48 months, the complete ratio of follow-up was 100%, 1 patient(2.7%) achieved complete response(CR), 10 cases(27.8%) were very good partial response(VGPR), 13 cases(36.1%) were partial response(PR), 6 cases(16.7%) were stable disease(SD), 4 cases(11.1%) were progressive and 2 died(5.6%). The overall response rate(ORR=CR+VGPR+PR)was 24/36(66.6%). The most common adverse was fatigue and dexamyelosuppression. Conclusion Lenalidomide plus low-dose dexamethasone is a safe and effective treatment for elderly MM patients. This combined treatment is recommended to elderly MM patients.
出处
《中华老年骨科与康复电子杂志》
2018年第1期20-22,共3页
Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)
基金
北京市自然科学基金自助项目(7162067)
