摘要
目的 :观察沙利度胺 (Thalidomide ,国内商品名 :反应停 )单药或联合地塞米松治疗多发性骨髓瘤(MultipleMyeloma ,MM )的疗效及副作用。 方法 :单药组 :男性 13例 ,女性 2例 ,中位年龄 58岁。其中 2例为初发的MM ;1例为原发性浆细胞白血病 (PCL) ;12例为难治性MM ,其中 3例为自体外周血干细胞移植 (AutoPBSCT)术后复发。反应停治疗起始剂量为 10 0mg/d ,根据患者耐受情况 ,逐渐加量 ,最高达 80 0mg/d。联合组 :男性 2 0例 ,女性 7例 ,中位年龄 56岁。其中初发 1例 ;1例为原发性PCL ;2 5例为难治MM ,其中 2例为自体外周血干细胞移植 (AutoPBSCT)术后复发。反应停剂量为 40 0mg/d左右加用地塞米松 40mg/天 ,第 1～ 4天 ,第 9～ 12天 ,第 17～2 0天 ,1个月为一个疗程。结果 :单药组 42 .9% (6/ 14 )的患者对治疗有效 ,其中 3例为完全缓解 (CR)或接近完全缓解(Near CR) ,1例有明显治疗反应 (Majorresponse) ,1例为部分缓解 (PR)。 12例难治性MM中 4例有效 (3 3 .3 % ) ;联合组有效率为 57.7% (15/ 2 6) ,其中 4例为CR或Near CR ,2例有明显治疗反应 ,9例为PR。 2 5例难治性MM中 11例有效 (44.0 % )。两组间在总有效率及难治病例的有效率方面均无显著差异。两组患者均出现不同程度的便秘、皮疹等副作用 ,但均?
Purpose:To investigate the effects and side- ef fects of thalidomide in the treatment of relapsed and refractory multiple myelom a (MM).Methods:There were thirteen men and two women aged 33～7 6 (median 58) years in thalidomide alone group. Two cases were newly diagnosed my eloma; twelve of them were refractory myeloma, including three relapsed cases wh o had experienced autologous peripheral blood stem cell transplantation (AutoPBS CT); another one is primary plasma cell leukemia. The starting dose was 100mg/d, escalating up to a maximum of 800mg/d. The combination group included twenty me n and seven women aged 40～81 (median 56) years of which case was newly diagnose d myeloma; twenty-five cases were refractory myeloma, two of whom relapsed after AutoPBSCT; another one was primary plasma cell leukemia. Dexamethasone 40mg/d w as used at d 1-4 , d 9-12 , d 17-20 when the dose of thalidomide increased to 400mg/d. Each cycle lasted for one month.Results: The total response rate was 42.9% and 57.7% in thalidomide alone group and in co mbination group, respectively. The response rate in refractory patients was 33.3 % and 44.0% in thalidomide alone group and in combination group, respectively. T here was no difference between the two groups in response rates. Both of the two groups had side effects of constipation and skin rash, etc. in different degree s but usually tolerable. Conclusions:Both thalidomide alone and thalidomide combined with dexamethasone was effective in the treatment of relap sed and refractory MM.
出处
《中国癌症杂志》
CAS
CSCD
2004年第1期68-71,共4页
China Oncology
