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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2018, Vol. 04 ›› Issue (01) : 20 -22. doi: 10.3877/cma.j.issn.2096-0263.2018.01.005

所属专题： 文献；

骨肿瘤

来那度胺联合小剂量地塞米松治疗老年多发性骨髓瘤患者的安全性观察
汤然1, 钟玉萍1,†(), 张佳佳1, 李新1, 安娜1, 申曼1   
  1. 1. 100043　首都医科大学附属北京朝阳医院西院血液科
  • 收稿日期:2017-07-21 出版日期:2018-02-05
  • 通信作者: 钟玉萍
  • 基金资助:
    北京市自然科学基金自助项目(7162067)

Treatment with lenalidomide and dexamethasone for elderly multiple myeloma

Ran Tang1, Yuping Zhong1,†(), Jiajia Zhang1, Xin Li1, Na An1, Man Shen1   

  1. 1. Department of Haematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, China
  • Received:2017-07-21 Published:2018-02-05
  • Corresponding author: Yuping Zhong
  • About author:
    Corresponding author: Zhong Yuping, Email:
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引用本文：

汤然, 钟玉萍, 张佳佳, 李新, 安娜, 申曼. 来那度胺联合小剂量地塞米松治疗老年多发性骨髓瘤患者的安全性观察[J]. 中华老年骨科与康复电子杂志, 2018, 04(01): 20-22.

Ran Tang, Yuping Zhong, Jiajia Zhang, Xin Li, Na An, Man Shen. Treatment with lenalidomide and dexamethasone for elderly multiple myeloma[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2018, 04(01): 20-22.

目的

观察来那度胺联合小剂量地塞米松（Rd）治疗老年多发性骨髓瘤的疗效及安全性。

方法

回顾性收集2013年6月至2017年6月首都医科大学附属北京朝阳医院西院血液科收治的老年骨髓瘤患者共36例，其中男性23例（63.9%），女性13例（36.1%），年龄（72.0±2.4）岁，均给予Rd方案治疗，具体为：来那度胺25 mg/qod或者10 mg/qd，d1~21，地塞米松10~20 mg/w，28 d为1个疗程。采用国际骨髓瘤工作组（IMWG）标准评价治疗效果，按照国际肿瘤组织毒副作用统一命名法的标准（NCICTCAE第3版）判断不良反应。

结果

36例患者获得满意随访，随访率100%，随访时间1~48个月，平均（20±3）个月。末次随访时，1例（2.7%）达到完全缓解，10例（27.8%）非常好的部分缓解，13例（36.1%）部分缓解，6例（16.7%）疾病稳定，4例（11.1%）疾病进展，2例（5.6%）死亡，总有效率为66.6%。不良反应主要为乏力及骨髓抑制。

结论

来那度胺联合小剂量地塞米松治疗老年多发性骨髓瘤患者，疗效好，患者耐受性好，可作为老年多发性骨髓瘤患者的推荐治疗方案。

关键词: 来那度胺, 老年人, 多发性骨髓瘤
Objective

To evaluate the efficacy and safety of lenalidomide plus low-dose dexamethasone in the treatment of elderly multiple myeloma (MM) patients.

Methods

The clinical records of 36 elderly MM patients were analyzed including 23 males (63.9%) and 13 females (36.1%). The average age was 72.0±2.4 years and all patients were treated with lenalidomide plus low-dose dexamethasone (lenalidomide 25 mg/qod or 10 mg/qd on day 1-21 of each 28-day cycle, dexamethasone 10-20 mg per week). Adverse reaction and therapeutic efficacy was determined by NCICTCAE (3rd edition) and IMWG.

Results

There were 36 patients well followed-up with an average of 20±3 months, range of 1-48 months, the complete ratio of follow-up was 100%, 1 patient (2.7%) achieved complete response (CR), 10 cases (27.8%) were very good partial response (VGPR), 13 cases (36.1%) were partial response (PR), 6 cases (16.7%) were stable disease (SD), 4 cases (11.1%) were progressive and 2 died (5.6%). The overall response rate (ORR=CR+VGPR+PR) was 24/36 (66.6%). The most common adverse was fatigue and dexamyelosuppression.

Conclusion

Lenalidomide plus low-dose dexamethasone is a safe and effective treatment for elderly MM patients. This combined treatment is recommended to elderly MM patients.

Key words: Lenalidomide, Aged, Multiple myeloma
表1 36例老年骨髓瘤患者的疾病特征
项目 ?
年龄（岁，±s） 72.0±2.4
性别[例（%）] ?
? 男 23（63.9）
? 女 13（36.1）
重链类型[例（%）] ?
? IgG 16（44.3）
? IgA 12（33.3）
? IgD 2（5.6）
轻链类型[例（%）] ?
? κ轻链 2（5.6）
? λ轻链 4（11.2）
β2微球蛋白≥5.5 mg/l[例（%）] 14（38.9）
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