羟基喜树碱联合方案治疗难治复发多发性骨髓瘤的临床观察

Clinical observation of hydroxycamptothecin,cyclophosphamide,vincristine and methylprednisolone combination therapy for relapse,refractory and multiple myeloma

为了探讨羟基喜树碱联合环磷酰胺+长春新碱+甲基强的松龙方案治疗难治或复发多发性骨髓瘤(MM)临床意义,对12例难治或复发MM患者实施羟基喜树碱联合方案化疗。羟基喜树碱(HCPT)6～8mg/(m2.d),d1～d5;环磷酰胺500mg/m2,d1;长春新碱0.5mg/d,d1～d4;甲基强的松龙1.0g,d1～d5;28d为1个周期。可评价10例患者中,8例(80%)病情获得不同程度的缓解,其中3例(37.5%)获得完全缓解(CR)和接近完全缓解(nCR),3例(37.5%)获部分缓解(PR),2例(25%)微小反应(MR);1例(10%)病情稳定(SD),1例(10%)病情进展(PD)。初步研究结果提示,HCPT联合方案是一个具有较好治疗前景的方案。

The objective of this study was to investigate the effect of the combination of hydroxycamptothecin, cyclophosphamide, vincristine and methytprednisolone in the treatment of relapsed, refractory and multiple myeloma （ MM ）. Twelve relapsed, refractory and multiple myeloma patients received hydroxycamptothecin [6-8 mg/（m^2 ＊ d）, d1--d5]cyclophosphamide （500 mg/m^2 , d1 ）, vincristine （0.5 mg/d, d1 --d4） , and pulse methylprednisolone （1.0 g, d1--d5 ）, every 4 weeks as one cycle. Three（37.5 %） cases obtained complete remission（CR） or near CR, 3 cases （37.5 % ） obtained partial remission（PR）, 2 （25 % ） had minimal responses（MR）, 1 （ 10 % ） was of no change and 1 （10 %） had progressive disease. The combination of hydroxycamptothecin, cyclophosphamide, vincristine and Methylprednisolone is a promising treatment regime for relapsed/refractory multiple myeloma.