达雷妥尤单抗联合苯达莫司汀治疗伴继发性髓外病变多发性骨髓瘤:单中心临床经验  

Single-center clinical experience of daratumumab combined with bendamustine in the treatment of multiple myeloma patients with secondary extramedullary disease

作　　者：周达[1] 王明月[1] 李喆[1] 柯晴[1] 岑洪[1] ZHOU Da;WANG Mingyue;LI Zhe;KE Qing;CEN Hong(Department of Hematological Oncology and Pediatric Oncology,Guangxi Medical University Cancer Hospital,Nanning 530022,China)

机构地区：[1]广西医科大学附属肿瘤医院淋巴血液及儿童肿瘤内科,南宁530022

出　　处：《中国癌症防治杂志》2024年第4期412-416,共5页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：广西自然科学基金区域高发疾病研究联合专项资助(2023GXNSFDA026019)。

摘　　要：目的探讨复发/难治性多发性骨髓瘤伴继发性髓外病变患者达雷妥尤单抗联合苯达莫司汀治疗的疗效和安全性。方法回顾性分析2021年1月至2023年12月于广西医科大学附属肿瘤医院住院治疗的复发/难治性多发性骨髓瘤伴继发性髓外病变患者的临床资料。所有患者均接受至少三线治疗仍疾病进展,然后采用达雷妥尤单抗和苯达莫司汀联合治疗。分别采用国际骨髓瘤工作组(International Myeloma Working Group,IMWG)标准和美国国家癌症研究所不良事件通用术语标准(NCI-CTCAE)5.0版评估其治疗疗效和安全性。结果共12例患者纳入分析,获完全缓解2例,部分缓解4例,微小缓解2例,疾病稳定1例,疾病进展3例,总缓解率为50%,中位无进展生存期为8个月。所有患者均出现血液学毒性,其中4例为Ⅲ~Ⅳ级;3例患者在治疗期间发生肺炎;均未发生治疗相关性死亡。结论达雷妥尤单抗联合苯达莫司汀在治疗复发/难治性伴继发性髓外病变的多发性骨髓瘤中显示出有效性,且毒性作用可控,值得在更大规模的患者群体中进一步验证。Objective To investigate the efficacy and safety of daratumumab combined with bendamustine in patients with relapsed/refractory multiple myeloma complicated by secondary extramedullary disease.Methods The clinical data of patients with relapsed/refractory multiple myeloma complicated by secondary extramedullary disease hospitalized in Guangxi Medical University Cancer Hospital from January 2021 to December 2023 were analyzed retrospectively.All patients had progressive disease on at least 3 prior treatment lines and followed by combination therapy with daratumumab and bendamustine.The efficacy and safety of the treatment were assessed based on the International Myeloma Working Group(IMWG)criteria and the National Cancer InstituteCommon Terminology Criteria for Adverse Events(NCICTCAE)version 5.0.Results A total of 12 patients were included in the analysis,with 2 achieving complete response,4 achieving partial response,2 achieving minimal response,1 achieving stable disease,and 3 experiencing progressive disease.The overall response rate was 50%,and the median progressionfree survival was 8 months.All patients experienced hematological toxicity,4 of which were gradeⅢ-Ⅳ.Additionally,3 patients developed pneumonia during treatment,no treatmentrelated deaths occurred.Conclusions The combination of daratumumab and bendamustine demonstrates effectiveness in treating relapsed/refractory multiple myeloma complicated by secondary extramedullary disease,with manageable toxicities.This result deserves further investigation with a larger patient population.

关 键 词：多发性骨髓瘤 复发/难治性 继发性髓外病变 达雷妥尤单抗 苯达莫司汀 

分 类 号：R733.3[医药卫生—肿瘤]