亚砷酸联合CTD化疗方案治疗复发难治性多发性骨髓瘤的疗效分析  

Effectiveness of arsenious acid combined with CTD chemotherapy in the treatment of relapsed and refractory multiple myeloma

作　　者：潘成林 李护君 闫志凌 姚瑶 姚若斯 李艳杰 徐开林 李振宇 PAN Chenglin;LI Hujun;YAN Zhiling;YAO Yao;YAO Ruosi;LI Yanjie;XU Kailin;LI Zhenyu(Department of Hematology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221002,China)

机构地区：[1]徐州医科大学附属医院血液科,江苏徐州221002

出　　处：《徐州医科大学学报》2022年第2期106-109,共4页Journal of Xuzhou Medical University

摘　　要：目的探讨亚砷酸联合环磷酰胺、沙利度胺、地塞米松(CTD)化疗方案治疗复发难治性多发性骨髓瘤(RRMM)的疗效和不良反应。方法回顾性分析使用亚砷酸联合CTD化疗方案治疗的32例既往多次化疗后复发或多次化疗未缓解的多发性骨髓瘤(MM)患者的临床资料,分析总体反应率(ORR)、临床获益率(CBR)、无进展生存期(PFS)、总体生存期(OS)、不良反应。结果32例患者全部能评价疗效,ORR为53.1%(17/32),CBR为68.7%(22/32);15例既往接受以硼替佐米为基础的治疗后出现疾病进展的患者应用亚砷酸联合CTD方案评估疗效,ORR为53.3%(8/15),CBR为80.0%(12/15)。32例患者的中位随访时间为10(3~33)个月,至随访截止,20例存活,中位PFS、OS时间分别为6.0(95%CI 4.52~7.48)、24.0(95%CI 17.14~30.85)个月,主要不良反应有胃肠道反应、白细胞减少、肝功能损害、手足麻木等。结论亚砷酸联合CTD化疗方案对于部分RRMM患者是一种较好的治疗选择,且对硼替佐米耐药的MM患者有一定疗效。Objective To investigate the therapeutic effect and adverse events of arsenious acid combined with cyclophosphamid,thalidomide and dexamethasone(CTD)chemotherapy in the treatment of relapsed and refractory multiple myeloma(MM).Methods A total of 32 relapsed and refractory MM patients who received arsenious acid combined with CTD chemotherapy were enrolled and their clinical data were retrospectively analyzed.Their overall survival rate(ORR),clinical benefit rate(CBR),progression-free survival(PFS),overall survival(OS),and adverse reactions were analyzed.Results All patients were evaluated for their therapeutic effects,with ORR of 50%(16/32)and CBR of 62.5%(20/32).For 15 patients who received arsenious acid combined with CTD chemotherapy due to the presence of progression after bortezomib-based therapy,their ORR was 53.3%(8/15),and CBR was 80.0%(12/15).The median follow-up time of these 32 patients was 10(3—33)mouths.At the end of follow-up visit,20 patients survived,and the median PFS and OS was 6.0(95%CI 4.52—7.48)and 24.0(95%CI 17.14—30.85),respectively.The main adverse reactions were digestive tract reaction,leukocytopenia,liver function damage,and peripheral neuropathy.Conclusions Arsenious acid combined with CTD chemotherapy is a good choice of treatment for some relapsed and refractory MM patients,and effective for bortezomib resistant MM patients to some extent.

关 键 词：亚砷酸 环磷酰胺 复发难治性多发性骨髓瘤 

分 类 号：R551.3[医药卫生—血液循环系统疾病]