CAJ | 학술논문

目的观察沙利度胺联合地塞米松(TD方案)治疗多发性骨髓瘤(MM)的疗效.方法 62例MM患者,其中复发和(或)难治组25例,平台期组37例.复发和(或)难治组治疗方案为:TD方案3个疗程后无效或进展者更换方案;有效者,继续使用TD方案,3个疗程后停用地塞米松,单独使用沙利度胺直到复发.平台期组的患者仅使用3个疗程的TD方案,再单独使用沙利度胺维持治疗.结果 25例复发和(或)难治的患者,前3个疗程TD方案的25例中20例总有效[非常好的部分缓解(VGPR)+部分缓解(PR)+进步(MR)]率为80%,但无完全缓解(CR)或接近完全缓解(nCR).有效者,经后3个疗程TD治疗后,1例获得nCR,而2例PR患者回到MR,无患者发展到NR或进展;对13例VGPR+PR+nCR患者,单独使用沙利度胺4～12个月(中位时间6.8个月)后复发.37例平台期的患者经上述方案治疗8～26个月(中位时间17.5个月)后复发.明显优于难治和(或)复发组的治疗效果(P＜0.001).结论沙利度胺联合地塞米松是难治和(或)复发MM有效治疗方案,也可作为平台期患者的维持治疗.
목적 관찰사리도알연합지새미송(TD방안)치료다발성골수류(MM)적료효.방법 62례MM환자,기중복발화(혹)난치조25례,평태기조37례.복발화(혹)난치조치료방안위:TD방안3개료정후무효혹진전자경환방안;유효자,계속사용TD방안,3개료정후정용지새미송,단독사용사리도알직도복발.평태기조적환자부사용3개료정적TD방안,재단독사용사리도알유지치료.결과 25례복발화(혹)난치적환자,전3개료정TD방안적25례중20례총유효[비상호적부분완해(VGPR)+부분완해(PR)+진보(MR)]솔위80%,단무완전완해(CR)혹접근완전완해(nCR).유효자,경후3개료정TD치료후,1례획득nCR,이2례PR환자회도MR,무환자발전도NR혹진전;대13례VGPR+PR+nCR환자,단독사용사리도알4～12개월(중위시간6.8개월)후복발.37례평태기적환자경상술방안치료8～26개월(중위시간17.5개월)후복발.명현우우난치화(혹)복발조적치료효과(P＜0.001).결론 사리도알연합지새미송시난치화(혹)복발MM유효치료방안,야가작위평태기환자적유지치료.
Objective To evaluate the effects of thalidomide in combination with dexamethasone (ID) in patients with relapsed or refractory multiple myeloma and in patients on stable phase. Methods Sixty-two patients with multiple myeloma were studied, include 25 with relapsed or refractory multiple myeloma, and 37 in stable phase. For the relapsed or refractory patients, thalidomide and dexamethasone was given at first three cycles, and then other regiments were given to no-response patients. For the all response patients, the second three cycles TD were enforced. On stable phase patients, thalidomide and dexamethasone were given as the second three cycles of relapsed or refractory patients. Then, thalidomide was given persistently until the disease relapse. Results All of the 25 relapsed or refractory patients were accepted the first 3 cycle TD treatment. The total response rate (VGPR+PR+MR) was 80 %. No complete remission (CR) and near CR(nCR) was gained. For the all response patients, the second three cycles TD were enforced. One patient achieved nCR. Thalidomide was given to all response patients. The median remission time was 6.8 (4～12) months. TD regimen was used to the 37 stable phase patients. The median remission time was 17.5 (8～26) months. The remission time of stable remission patients is longer then that of relapsed or refractory patients (P <0.001). Conclusion The combination of thalidomide and dexamethasone is a feasible and active regimen in the treatment of relapsed or refractory, and stable phase myeloma patients.