沙利度胺联合地塞米松治疗复发和（或）难治及平台期多发性骨髓瘤疗效分析  

Combination therapy with thalidomide plus dexamethasone for patients with relapsed or refractory multiple myeloma and for patients on stable phase multiple myeloma

作　　者：李利红[1] 李燕郴[1] 刘爱军[1] 王晶[1] 吴垠[1] 陈文明[1] 

机构地区：[1]首都医科大学附属北京朝阳医院血液肿瘤科 北京市多发性骨髓瘤医疗研究中心,北京100020

出　　处：《白血病．淋巴瘤》2008年第3期192-194,199,共4页Journal of Leukemia & Lymphoma

基　　金：北京市科技新星计划（954812300）

摘　　要：目的观察沙利度胺联合地塞米松（TD方案）治疗多发性骨髓瘤（MM）的疗效。方法62例MM患者，其中复发和（或）难治组25例，平台期组37例。复发和（或）难治组治疗方案为：TD方案3个疗程后无效或进展者更换方案；有效者，继续使用TD方案，3个疗程后停用地塞米松，单独使用沙利度胺直到复发。平台期组的患者仅使用3个疗程的TD方案，再单独使用沙利度胺维持治疗。结果25例复发和（或）难治的患者，前3个疗程TD方案的25例中20例总有效[非常好的部分缓解（VGPR）＋部分缓解（PR）＋进步（MR）]率为80％，但无完全缓解（CR）或接近完全缓解（nCR）。有效者，经后3个疗程TD治疗后，1例获得nCR，而2例PR患者回到MR，无患者发展到NR或进展；对13例VGPR＋PR＋nCR患者，单独使用沙利度胺4～12个月（中位时间6．8个月）后复发。37例平台期的患者经上述方案治疗8～26个月（中位时间17．5个月）后复发。明显优于难治和（或）复发组的治疗效果（P〈0．001）。结论沙利度胺联合地塞米松是难治和（或）复发MM有效治疗方案，也可作为平台期患者的维持治疗。Objective To evaluate the effects of thalidomide in combination with dexamethasone （TD） in patients with relapsed or refractory multiple myeloma and in patients on stable phase. Methods Sixty-two patients with multiple myeloma were studied, include 25 with relapsed or refractory multiple myeloma, and 37 in stable phase. For the relapsed or refractory patients, thalidomide and dexamethasone was given at first three cycles, and then other regiments were given to no-response patients, For the all response patients, the second three cycles TD were enforced, On stable phase patients, thalidomide and dexamethasone were given as the second three cycles of relapsed or refractory patients, Then, thalidomide was given persistently until the disease relapse. Results All of the 25 relapsed or refractory patients were accepted the first 3 cycle TD treatment. The total response rate （VGPR＋PR＋MR） was 80 %. No complete remission （CR） and near CR（nCR） was gained, For the all response patients, the second three cycles TD were enforced. One patient achieved nCR. Thalidomide was given to all response patients. The median remission time was 6.8 （4～ 12） months. TD regimen was used to the 37 stable phase patients. The median remission time was 17.5 （8～26） months. The remission time of stable remission patients is longer then that of relapsed or refractory patients （P 〈0.001）. Conclusion The combination of thalidomide and dexamethasone is a feasible and active regimen in the treatment of relapsed or refractory, and stable phase myeloma patients,

关 键 词：多发性骨髓瘤 药物疗法 联合 

分 类 号：R733.3[医药卫生—肿瘤]