持续低剂量环磷酰胺联合泼尼松治疗复发、难治性多发性骨髓瘤84例  

Continuous low-dose cyclophosphamide and prednisone treatment of 84 cases relapsed and refractory multiple myeloma

作　　者：郭列平[1] 周帆[1] 韦苇[1] 张忆梓[1] 石昊天[1] 凌晨晖[1] 李璐[1] 姜男[1] 侯健[1,2] 

机构地区：[1]上海市闸北区中心医院血液肿瘤科,200070 [2]第二军医大学长征医院血液科

出　　处：《白血病．淋巴瘤》2012年第5期290-293,共4页Journal of Leukemia & Lymphoma

摘　　要：目的探讨持续低剂量环磷酰胺联合泼尼松治疗复发、难治性多发性骨髓瘤（MM）的疗效和患者不良反应。方法84例复发、难治性MM患者中男46例，女38例，其中81例可评估，年龄45～91岁，平均年龄69．7岁。予持续低剂量环磷酰胺（50mg／d）联合泼尼松（15mg／d）口服，每月随访1次。结果随访时间1～71个月，平均随访时间23．5个月。可评估患者81例，52例（64．2％）有效，其中2例（2．5％）完全缓解（CR），21例（25．9％）部分缓解（PR），29例（35．8％）微小缓解（MR），19例（23．5％）无变化（NC），10例（1213％）疾病进展（PD）。起效时间1～4个月，中位起效时间2个月，有效组患者中位无进展生存时间（PFS）和总生存时间（OS）分别为18个月（95％口12．8～2312）、29个月（95％凹24．1．33．9），无效组患者分别为4个月（95％C12．5～5．5）、6个月（95％口5．4—6．6），两组比较差异均有统计学意义（均19〈0．05）。主要不良反应有乏力、恶心、自细胞减少、血糖增高和肺部感染。无患者因不良反应而退出研究。结论持续低剂量环磷酰胺联合泼尼松是复发、难治性MM患者的治疗选择之一。Objective To evaluate the efficacy and tolerability of continuous low-dose cyclophosphamide and prednisone treatment of relapsed and refractory multiple myeloma. Methods 84 relapsed and refractory multiple myeloma patients were enrolled, including 46 males and 38 females, the assess patients of 81 cases with average age of 69.7 （45-91） years. They were treated continuous with oral cyelophosphamide （50 mg/d） and prednisone （15 mg/d） and monthly follow-up. Results Average follow-up time were 23.5（1-71）months. The assessed patients were 81 cases, with 52 cases （64.2 %） responded. There were 2 cases（2.5 %）CR, 21 cases（25.9 %） of PR, 29 eases（35.8 %）MR,19 cases（23.5 %）NC and 10 eases （12.3 %）PD. The median time to response was 2 months. In the patients who responded to the treatment, the median progression-free survival（PFS）and overall survival （OS） were 18（95 %CI 12.8-23.2）,29（95 %CI 24.1- 33.9）months. In the non-responding patients, the PFS and OS were 4（95 % CI 2.2-5.8） and 6（95 % CI 4.9- 7.1 ）months. Two groups were statistically siguificant（P〈0.05）. The most common toxicities included fatigue, nausea, neutropenia, hyperglycemia and lung infection. No patient withdrew from the study because of toxicity. Conclusions Continuous low-dose cyclophosphamide combined prednisone is a treatment options for relapsed and refractory MM patients.

关 键 词：多发性骨髓瘤 环磷酰胺 泼尼松 复发 难治 

分 类 号：R733.3[医药卫生—肿瘤]