泊马度胺为主方案治疗复发难治性多发性骨髓瘤的临床效果研究  

Clinical Effects of Pomalidomide-Based Regimen in the Treatment of Relapsed and Refractory Multiple Myeloma

作　　者：杨满[1] 黄琰[1] 张灵秀[1] 吕国庆[1] 朱璐瑶 刘宪凯 郭燕[1] YANG Man;HUANG Yan;ZHANG Ling-Xiu;LYU Guo-Qing;ZHU Lu-Yao;LIU Xian-Kai;GUO Yan(Department of Hematology,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang Key Laboratory of Lymphoma Molecular Diagnosis and Treatment,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院血液科,新乡市淋巴瘤分子诊疗重点实验室,河南新乡453100

出　　处：《中国实验血液学杂志》2025年第2期431-436,共6页Journal of Experimental Hematology

基　　金：2019年度新乡医学院第一附属医院青年培育基金项目(QN-2019-B01);新乡市科技攻关项目(GG2020029);新乡市淋巴瘤分子诊疗重点实验室河南省医学科技联合共建项目和软科学项目(LHGJ20210533)。

摘　　要：目的:研究泊马度胺为主方案治疗复发难治性多发性骨髓瘤(RRMM)的临床效果。方法:选取2020年11月至2023年1月新乡医学院第一附属医院血液科收治的RRMM患者60例作为研究对象,其中15例采用PDD方案(泊马度胺+达雷妥尤单抗+地塞米松),45例采用PCD方案(泊马度胺+环磷酰胺+地塞米松),观察并评价临床效果。结果:所有患者中位疗程5(2-11)个,总体反应率(ORR)为75.0%;采用PDD方案的患者ORR为73.3%,采用PCD方案的患者ORR为75.6%。46例非高危细胞遗传学异常患者的ORR为86.9%,显著高于14例高危细胞遗传学异常患者的35.7%(χ^(2)=15.031,P<0.05)。所有患者的中位PFS为8.0(95%CI:6.8-9.1)个月,中位OS为14.0(95%CI:11.3-16.7)个月。PDD方案中非高危细胞遗传学异常患者的PFS和OS均显著高于高危细胞遗传学异常患者[PFS:7.0(95%CI:4.6-9.3)个月vs 4.0(95%CI:3.1-4.8)个月,χ^(2)=5.120,P<0.05;OS:未达到vs 6.0(95%CI:1.1-10.9)个月,χ^(2)=9.870,P<0.05];PCD方案中非高危细胞遗传学异常患者的PFS和OS也均显著高于高危细胞遗传学异常患者[PFS:9.0(95%CI:6.2-11.8)个月vs 6.0(95%CI:5.4-6.6)个月,χ^(2)=14.396,P<0.05;OS:未达到vs 11.0(95%CI:6.4-15.6)个月,χ^(2)=7.471,P<0.05]。结论:泊马度胺为主的方案治疗RRMM具有较好的临床效果,且安全性良好。Objective:To study the clinical effects of pomalidomide-based regimen in the treatment of relapsed and refractory multiple myeloma(RRMM).Methods:60 patients with RRMM in hematology department of the First Affiliated Hospital of Xinxiang Medical University from November 2020 to January 2023 were selected.Among them,15 cases were treated with PDD regimen(pomalidomide+daratumumab+dexamethasone),and 45 cases were treated with PCD regimen(pomalidomide+cyclophosphamide+dexamethasone).The clinical effects were evaluated.Results:The median number of treatment cycles for the entire cohort was 5(2-11),with an overall response rate(ORR)of 75.0%.The ORR of patients treated with PDD regimen was 73.3%,while the ORR of patients treated with PCD regimen was 75.6%.The ORR of 46 patients with non high-risk cytogenetic abnormalities(non-HRCA)was 86.9%,significantly higher than the 35.7%of 14 patients with HRCA(χ^(2)=15.031,P<0.05).The median PFS for all patients was 8.0(95%CI:6.8-9.1)months and the median OS was 14.0(95%CI:11.3-16.7)months.Among patients treated with PDD regimen,the PFS and OS of patients with non-HRCA were significantly higher than those of patients with HRCA[PFS:7.0(95%CI:4.6-9.3)months vs 4.0(95%CI:3.1-4.8)months,χ^(2)=5.120,P<0.05;OS:not reached vs 6.0(95%CI:1.1-10.9)months,χ^(2)=9.870,P<0.05].Among patients treated with PCD regimen,the PFS and OS of patients with non-HRCA were significantly higher than those of patients with HRCA[PFS:9.0(95%CI:6.2-11.8)months vs 6.0(95%CI:5.4-6.6)months,χ^(2)=14.396,P<0.05;OS:not reached vs 11.0(95%CI:6.4-15.6)months,χ^(2)=7.471,P<0.05].Conclusion:The pomalidomide-based regimen has a good clinical effect and safety in the treatment of RRMM.

关 键 词：多发性骨髓瘤 复发难治 泊马度胺 临床效果 

分 类 号：R733.3[医药卫生—肿瘤]