沙利度胺联合治疗高危骨髓增生异常综合征及骨髓纤维化的疗效观察

An observation of combined therapy with thalidomide in high risk MDS and myelofibrosis

目的:探讨骨髓增生异常综合征(MDS)高危患者及骨髓纤维化的有效治疗方法。方法:我们采用联合应用沙利度胺治疗高危MDS 22例及骨髓纤维化8例。结果:在19 例可评价的MDS病例中完全缓解7 例(36.8%),部分缓解4例(21.1%),进步3例(15.8%),无效5例(26.3%)。8例骨髓纤维化中4例临床血液学完全缓解,4例贫血症状得到改善。在5例需长期输血的患者中,4 例贫血情况得到缓解不再需要输血。3 例血小板减少患者中,2例血小板计数增加了50%以上。8 例脾大者均有缩小,5 例缩小50%以上。毒副作用小。结论:沙利度胺联合治疗高危MDS及骨髓纤维化有明显的疗效,且毒副作用小,值得扩大病例进一步研究及推广。

Objective:To investigate the efficacy in treating high risk Myelodysplastic Syndrome (MDS) and Myelofibrosis.Method:22 cases of high risk MDS and 8 cases of myelofibrosis were treated by combined therapy with thelidomide.Result:Except that 1 case stopped using thalidomide for suffering from diabetic neuropathy and 2 for allergy.19 cases had been evaluated. 7 cases achieved CR ( 36.8%), 4 achieved PR ( 21.1%), 4 got better ( 15.8%), and there were no effect on 5 patients ( 26.3%). In 8 patients with myelofibrosis, 4 achieved CR clinically while the other 4 became better in anemia. As to the 5 patients requiring long-time blood transfusions, 4 cases became transfusion-independent. Among the 3 cases of thrombocytopenia, 2 platelet counts increased by more than 50%. All 8 splenomegaly improved to different degrees, the splcen became even smaller by more than 50% in 5 cases. Mild side and toxic effects were observed.Conclusion:Combined therapy with thalidomide has significant effect in high risk of MDS and myelofibrosis patients. There are mild side or toxic effects. But we need more cases to draw the conclusion.