拓泊替康联合CDT方案治疗难治性复发性多发性骨髓瘤的疗效

Effects of Topotecan Combined with CDT for the Treatment of Relapsed Refractory Multiple Myeloma

目的:观察拓泊替康联合CDT方案治疗难治性复发性多发性骨髓瘤的疗效及不良反应。方法:8例多发性骨髓瘤患者给予拓泊替康(2mg,1次/d)、CTX(0.2g,1次/d)、DEX(10mg1次/12h)静脉滴注,连续应用5d,21d为一疗程;同时给予沙利度胺口服,起始剂量为100mg/d,1周后逐步加量并调整至100～200mg/d,长期维持。连续应用6个疗程后评估疗效和不良反应,有效患者继续沙利度胺维持治疗。结果:拓泊替康联合CDT方案治疗复发难治性MM,总有效率87.5%(7/8),完全缓解1例(12.5%),部分缓解4例(50.0%),进步2例(25.0%),无效1例(12.5%)。不良反应主要为轻度骨髓抑制、消化道反应、手指发麻及便秘等,经对症治疗后无相关性死亡发生。结论:拓泊替康联合CDT方案治疗复发难治性多发性骨髓瘤是一种有效、能耐受的挽救性治疗方案,值得临床进一步推广使用。

Objective ：To evaluate the efficacy and side effects of topotecan combined with CDT for the treatment of relapsed refractory multiple myeloma（MM）.Methods ：8 patients with relapsed refractory MM were treated with topotecan, cyclophosphamide and dexamethasone for 5 days, 21 days per cycle.Meanwhile they were orally administered thalidomide 100 mg/d, and then oneweek later orally thalidomide was added to 100-200 mg/d.After 6 cycles of treatment.Response and the side effects were evaluated.Patients responsed to the regimen were continued the treatment of thalidomide.Results ：The overall response was 87.5%（7/8）, CR 12.5%（1/8）, PR 50.0%（4/8）, MR 25.0%（2/8）.Alter amedian follow.The major adverse reactions were digestive tract reaction, leukocytopenia, liver function damage, peripheral neuropathy.They were mild, and could betolerated.Conclusion ：The combination of topotecan and CDT is a fesible and active regimen in treatment of relapsed refractory MM with better compliance in general.