[1]汤然,钟玉萍,张佳佳,等.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,(01):20-22.[doi:10.3877/cma.j.issn.2096-0263.2018.01.005]
 Tang Ran,Zhong Yuping,Zhang Jiajia,et al.Treatment with lenalidomide and dexamethasone for elderly multiple myeloma[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2018,(01):20-22.[doi:10.3877/cma.j.issn.2096-0263.2018.01.005]
点击复制

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()
分享到:

中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2018年01期
页码:
20-22
栏目:
骨肿瘤
出版日期:
2018-01-31

文章信息/Info

Title:
Treatment with lenalidomide and dexamethasone for elderly multiple myeloma
作者:
汤然钟玉萍张佳佳李新安娜申曼
100043 首都医科大学附属北京朝阳医院西院血液科
Author(s):
Tang Ran Zhong Yuping Zhang Jiajia Li Xin An Na Shen Man
Department of Haematology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, China
关键词:
来那度胺 老年人 多发性骨髓瘤
Keywords:
Lenalidomide Aged Multiple myeloma
DOI:
10.3877/cma.j.issn.2096-0263.2018.01.005
文献标志码:
A
摘要:
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。
Abstract:
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.

参考文献/References:

1 Sharpe AH, Abbas AK. T-cell costimulation--biology, therapeutic potential, and challenges [J]. N Engl J Med, 2006, 355(10): 973-975.
2 Hayashi T, Hideshima T, Akiyama M, et al. Molecular mechanisms whereby immunomodulatory drugs activate natural killer cells: clinical application [J]. Br J Haematol, 2005, 128(2): 192-203.
3 Bartlett JB. Lenalidomide enhances tumor killing invitro during ADCC mediated by Trastuzumab, Cetuximab, and Rituximab [J]. J Clin Oncol, 2007, 25(18S): 3023.
4 Wu L, Adams M, Carter T, et al. Lenalidomide enhances natural killer cell and monocyte-mediated antibody-dependent cellular cytotoxicity of rituximab-treated CD20 (+) tumor cells [J]. Clin Cancer Res, 2008, 14(14): 4650-4657.
5 Shadduck RK, Latsko JM, Rossetti JM, et al. Recent advances in myelodysplastic syndromes [J]. Exp Hematol, 2007, 35(4 Suppl 1): 137-143.
6 Altekruse SF, Kosary CL, Krapcho M, et al. SEER Cancer Statistics Review, 1975-007. Bethesda (MD): National Cancer Institute, 2010. http://seer.cancer.gov/csr/1975_2007/index.html.
7 Lu J, Lu J, Chen W, et al. Clinical features and treatment outcome in newly diagnosed Chinese patients with multiple myeloma: Results of a multicenter analysis [J]. Blood Cancer, 2014, 4: 239.
8 Palumbo A, Bringhen S, Ludwig H, et al. Personalized therapy in multiple myeloma according to patient age and vulnerability: a report of the European Myeloma Network (EMN) [J]. Blood, 2011, 118(17): 4519-4529.
9 Kumar SK, Rajkumar SV, Dispenzieri AA, et al. Improved survival in multiple myeloma and the impact of novel therapies [J]. Blood, 2008, 111(5): 2516-2520.
10 Kumar SK, Dispenzieri A, Lacy MQ, et al. Continued improvement in survival in multiple myeloma: changes in early mortality and outcomes in older patients [J]. Leukemia, 2014, 28(5): 1122-1128.
11 Durie BG, Harousseau JL, Miguel JS, et al. International uniform response criteria for multiple myeloma [J]. Leukemia, 2006, 20(9): 1467-1473.
12 Davies F, Baz R. Lenalidomide mode of action: linking bench and clinical findings [J]. Blood Rev, 2010, 24(Suppl 1): S13-S19.
13 Zhong YP, Zhang YZ, Liao AJ, et al. Geriatric assessment to predict survival and the risk of serious adverse events in elderly newly diagnosed multiple myeloma patients: a multicenter study in China [J]. Chin Med J, 2017, 130(2): 130-133.
14 Dimopoulos MA, Chen C, Spencer A, et al. Long-term follow-up on overall survival from the MM-009 and MM-010 phase III trials of lenolidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma [J]. Leukemia, 2009, 23: 2147-2152.
15 Hou J, Du X, Jin J, et al. A multicenter, open-label, phase 2 study of lenalidomide plus low-dose dexamethasone in Chinese patients with relapsed/refractory multiple myeloma: the MM-021 trial [J]. J Hematol Oncol, 2013, 6: 41.

相似文献/References:

[1]沈鹏程 朱立帆 蒋富贵 鞠文 徐能 李晓林.锁定钢板结合重建肱骨内侧柱治疗老年不稳定型肱骨近端骨折的疗效分析[J].中华老年骨科与康复电子杂志,2015,(02):7.[doi:10.3877/cma.j.issn.2096-0263.2015.02.002]
 Shen Pengcheng,Zhu Lifan,Jiang Fugui,et al.Clinical research of locking plate combined with medial column mechanical support for unstable fractures of the proximal humerus in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2015,(01):7.[doi:10.3877/cma.j.issn.2096-0263.2015.02.002]
[2]刘文宣 张宇宸 刘文聪 高霞 李涛 张晓琳.CTR 基因多态性与老年男性骨质疏松的相关性研究[J].中华老年骨科与康复电子杂志,2015,(02):19.[doi:10.3877/cma.j.issn.2096-0263.2015.02.004]
 Liu Wenxuan,Zhang Yuchen,Liu Wencong,et al.Association between calcitonin receptor gene polymorphism and osteoporosis in elderly men[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2015,(01):19.[doi:10.3877/cma.j.issn.2096-0263.2015.02.004]
[3]董仁卫 郭琪 王家仲 王连成.老年人群肌力水平与心血管疾病 三大危险因素的相关性研究[J].中华老年骨科与康复电子杂志,2015,(02):29.[doi:10.3877/cma.j.issn.2096-0263.2015.02.006]
 Dong Renwei,Guo Qi,Wang Jiazhong,et al.The association between muscle strength level and three major risk factors of cardiovascular disease in elderly population[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2015,(01):29.[doi:10.3877/cma.j.issn.2096-0263.2015.02.006]
[4]李森磊,孙立,杨先腾,等.老年髋关节置换术后认知功能障碍的危险因素分析[J].中华老年骨科与康复电子杂志,2016,(02):71.[doi:10.3877/cma.j.issn.2096-0263.2016.02.002]
 Li Senlei,Sun Li,Yang Xianteng,et al.Risk factors analysis for postoperative cognitive dysfunction in  elderly patients undergoing hip arthroplasty[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):71.[doi:10.3877/cma.j.issn.2096-0263.2016.02.002]
[5]钟俊青,王连成.快速外科通道理念对老年股骨转子间骨折围手术期康复指导的前瞻性研究[J].中华老年骨科与康复电子杂志,2016,(02):87.[doi:10.3877/cma.j.issn.2096-0263.2016.02.005]
 Zhong Junqing,Wang Liancheng..Prospective study of the effect of fast track surery on peri-operative rehabilitation of elderly intertrochanteric fracture[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):87.[doi:10.3877/cma.j.issn.2096-0263.2016.02.005]
[6]赵德伟,马志杰,杨磊,等.多孔钽金属涂层髋关节假体置换治疗老年股骨颈骨折的临床疗效观察[J].中华老年骨科与康复电子杂志,2016,(02):92.[doi:10.3877/cma.j.issn.2096-0263.2016.02.006]
 Zhao Dewei,Ma Zhijie,Yang Lei,et al.Clinical investigation of hip implants by using porous tantalum coating in the treatment of elderly femoral neck fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):92.[doi:10.3877/cma.j.issn.2096-0263.2016.02.006]
[7]吴啸波,裴宝瑞.老年髋部骨折围手术期相关问题的研究进展[J].中华老年骨科与康复电子杂志,2016,(02):114.[doi:10.3877/cma.j.issn.2096-0263.2016.02.010]
 Wu Xiaobo,Pei Baorui..Perioperative related problems of surgery in elderly patients with hip fractures[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):114.[doi:10.3877/cma.j.issn.2096-0263.2016.02.010]
[8]宋会平,张柳.阿仑膦酸钠治疗老年女性严重骨质疏松症患者的疗效分析[J].中华老年骨科与康复电子杂志,2016,(03):141.[doi:10.3877/cma.j.issn.2096-0263.2016.03.003]
 Song Huiping,Zhang Liu.Effcacy analysis of alendronate in the treatment of severe osteoporosis in senile women[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):141.[doi:10.3877/cma.j.issn.2096-0263.2016.03.003]
[9]柴仪,田伟明,温志刚.经皮椎体后凸成形术治疗高龄骨质疏松性椎体压缩骨折的疗效分析[J].中华老年骨科与康复电子杂志,2016,(03):150.[doi:10.3877/cma.j.issn.2096-0263.2016.03.005]
 Chai Yi,Tian Weiming,Wen Zhigang.Curative effective analysis of percutaneous kyphoplasty for osteoporotic vertebral compression fracture in senile patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):150.[doi:10.3877/cma.j.issn.2096-0263.2016.03.005]
[10]陈旭光,张天燕,单新1,等.围术期抑郁对老年骨科手术患者单核细胞组织因子表达及血小板功能的影响[J].中华老年骨科与康复电子杂志,2016,(03):155.[doi:10.3877//cma.j.issn2096-2063.2016.03.006]
 Chen Xuguang,Zhang Tianyan,Shan Xin,et al.Effect of depressive disorder on tissue factor expression of monocytes and platelet function in elderly patients undergoing orthopaedic surgery[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2016,(01):155.[doi:10.3877//cma.j.issn2096-2063.2016.03.006]

备注/Memo

备注/Memo:
基金项目:北京市自然科学基金自助项目(7162067)
更新日期/Last Update: 2018-01-31