小剂量沙利度胺联合泼尼松治疗原发性骨髓纤维化14例

Observation on Effect and Adverse Reactions of Low- Dose Thalidomide Combined with Prednisone in Treating Primary Myelofibrosis in 14 Cases

目的观察小剂量沙利度胺联合泼尼松治疗原发性骨髓纤维化(IMF)的疗效及其安全性。方法收集14例诊断明确的原发性骨髓纤维化患者,给予沙利度胺联合泼尼松治疗,观察患者血常规及脾脏大小变化,评估其疗效,同时密切观察药物的不良反应。结果 14例患者中,10例获得临床进步,其中血红蛋白提高7例(50.00%),血小板升高3例(21.43%),脾脏缩小7例(50.00%);3例稳定;1例于用药1月后死于心衰。14例患者对小剂量沙利度胺及泼尼松均能耐受,不良反应主要是手足麻木、嗜睡、便秘、水肿、乏力,但均为Ⅰ度。结论沙利度胺联合泼尼松治疗原发性骨髓纤维化患者,临床疗效较明显,不良反应能耐受。

Objective To explore the efficacy and safety of low-dose thalidomide combined with prednisone in the treatment of primary myelofibrosis. Methods 14 cases of primary myelofibrosis were treated with thalidomide combined with prednisone. The changes of blood routine and spleen size were observed. The curative effect was evaluated. At the same time the adverse reactions were closely ob-served. Resuts Of 14 cases of primary myelofibrosis, 10 cases obtained the clinical progress, among them, hemoglobin was increased in 7 cases （ 50. 00%） , platelet was increased in 3 cases （ 21. 43%） , spleen was diminished in 7 cases （ 50. 00%）;3 cases were stable;1 case died of heart failure in 1 month after medication. 14 cases were tolerable to low-dose thalidomide and prednisone. The adverse reac-tions mainly were deadlimb, drowsiness, constipation, edema and fatigue, which were mild. Conclusion Thalidomide combined with pred-nisone has significant effect for treating primary myelofibrosis and the adverse reactions are tolerable.