不同剂量来那度胺治疗初诊中晚期多发性骨髓瘤疗效分析  

Efficacy Analysis of Different Doses of Lenalidomide in the Treatment of Newly Diagnosed Advanced Multiple Myeloma

作　　者：李青青 梁立新[1] 令狐锐[1] 辛小海[1] 周冰[1] 齐云晓 LI Qingqing;LIANG Lixin;LINGHU Rui;XIN Xiaohai;ZHOU Bing;QI Yunxiao(Department of Hematology,Sanmenxia Central Hospital,Sanmenxia,Henan 472000,China)

机构地区：[1]三门峡市中心医院血液内科,河南三门峡472000

出　　处：《临床研究》2024年第12期70-73,共4页Clinical Research

摘　　要：目的分析不同剂量来那度胺对初诊中晚期多发性骨髓瘤(MM)患者的应用价值。方法抽取三门峡市中心医院2021年1月至2023年1月收治的84例初诊中晚期多发性骨髓瘤患者为研究对象,均给予PRD(硼替佐米1.3 mg/m^(2)/d,来那度胺及地塞米松20 mg/d)方案化疗,按随机数字表法分为对照组和研究组,各42例,其中对照组来那度胺剂量为25 mg/d,研究组来那度胺剂量为10 mg/d,对比两组患者两疗程后治疗有效率、患者生存率、临床指标及药物毒副作用发生率。结果研究组有效率低于对照组,但组间差异无统计学意义(P>0.05)。研究组1年无进展生存期(PFS)率及1年总生存期(OS)率均高于对照组,但组间差异无统计学意义(P>0.05)。研究组球蛋白下降比率高于对照组,β2微球蛋白(β2-MG)下降比率、免疫固定电泳转阴率及尿本周氏蛋白阴性率均低于对照组,但组间差异均无统计学意义(P>0.05)。研究组药物毒副作用(白细胞减少、血小板减少、周围神经病变)发生率低于对照组,差异有统计学意义(P<0.05)。结论低剂量来那度胺治疗MM与常规治疗剂量具有相等的临床疗效,均能调节免疫功能,延长生存期,但能够减少药物毒副作用发生情况,整体安全性可观,应用价值较高。Objective To analyze the application value of different doses of lenalidomide in patients with newly diagnosed advanced multiple myeloma(MM).Methods A total of 84 patients with newly diagnosed advanced multiple myeloma treated at Sanmenxia Central Hospital from January 2021 to January 2023 were selected for the study.All patients received PRD(bortezomib 1.3 mg/m^(2)/d,lenalidomide and dexamethasone 20 mg/d)chemotherapy.They were randomly divided into a control group and a study group,each comprising 42 patients.The control group received lenalidomide at a dose of 25 mg/day,while the study group received lenalidomide at a dose of 10 mg/day.The treatment efficacy after two cycles,patient survival rates,clinical indicators,and the incidence of drug side effects were compared between both groups.Results The efficacy rate in the study group was lower than that in the control group,but the difference was not statistically significant(P>0.05).The one-year progression-free survival(PFS)rate and one-year overall survival(OS)rate in the study group were both higher than those in the control group,but the differences were not statistically significant(P>0.05).The decrease rate of globulin in the study group was higher than that in the control group,while the decrease rates ofβ2-microglobulin(β2-MG),the rate of negative immunofixation electrophoresis,and the rate of negative Bence Jones protein in urine were all lower than those in the control group,with no significant differences between the groups(P>0.05).However,the incidence of drug side effects(leukopenia,thrombocytopenia,peripheral neuropathy)in the study group was lower than that in the control group,with a statistically significant difference(P<0.05).Conclusion Low-dose lenalidomide treatment for MM has equivalent clinical efficacy to conventional dosing but can reduce the incidence of drug side effects.This approach provides considerable safety and high application value while effectively regulating immune function and prolonging survival.

关 键 词：不同剂量 来那度胺 多发性骨髓瘤 临床疗效 生存期 药物毒副作用 

分 类 号：R683.42[医药卫生—骨科学]