DCEP-T方案治疗复发或难治性多发性骨髓瘤疗效观察

DCEP-T:An Effective,Tolerated,Salvage Combination Chemotherapy for Relapsed or Refractory Multiple Myeloma

目的观察DCEP-T方案挽救性治疗复发或难治性多发性骨髓瘤的疗效。方法28例复发或难治性骨髓瘤患者,接受地塞米松(20～40)mg/d,环磷酰胺200mg/d,鬼臼乙叉甙40mg/m2,顺铂每天10mg/m2,第1～4天,静脉注射;沙利度胺(100～200)mg/d,每晚顿服;4周为1个疗程,至少2个疗程。结果2个疗程后18例患者获得不同程度的缓解,总有效率为64.3%,其中VGPR4例(14.3%),PR14例(50.0%)。伴有髓外侵犯的9例患者中4例髓外肿块完全消失,2例明显变小,有效率为66.7%(6/9)。最常见的非血液学毒性为恶心、呕吐(32.1%),其次为便秘(25.0%)。结论DCEP-T是一种有效的、能耐受的挽救性治疗复发或难治性骨髓瘤的方案,尤其对骨髓瘤髓外侵犯疗效肯定。

Objective To investigate the efficacy of DCEP-T regimen in treatment of patients with relapsed or refractory multiple myeloma（MM）. Methods Twenty-eight patients （19 male and 9 female, median age is 49 years） with refractory or relapsed myeloma had been treated with DCEP-T for at least two cycles. The regimen consisted of 4 days of intravenous dexamethasone（20-40）mg/d, cyclophospha- mide 200 mg/d, etoposide 40 mg/m^2 , cisplatin 10 mg/m^2 , and daily thalidomide （100-200） mg/d in a 4- week cycle. Results After two cycles of DCEP-T,4 patients （14. 3%） achieved very good complete response,and 14 patients （50. 0%） had a partial response. So the overall response rate was 64. 3%. Among the 9 patients with extramedullary evolvement, plasmacytoma completely disappeared in 4 patients, and decreased markedly in 2 patients, the response rate was 66. 7% （6/9）. The most common nonhernatologic toxicities were nausea and vomiting （32. 1% ）, followed by constipation （ 25.0% ）. Conclusion DCEP-T is an effective,tolerable, salvage combination chemotherapy for relapsed or refractory MM, as well as in extramedullary evolvement.