改良DCEP方案治疗复发/难治性多发性骨髓瘤的疗效分析

Therapeutic efficacy of a modified DCEP for relapsed/refractory multiple myeloma

目的观察改良DCEP方案(地塞米松、环磷酰胺、依托泊苷及顺铂)治疗复发/难治性多发性骨髓瘤(MM)的疗效和不良反应。方法入选2015年3月至2017年2月在解放军总医院第一附属医院老年肿瘤科住院并接受改良DCEP方案治疗的复发/难治性MM患者5例,记录患者的临床特征,包括年龄、性别、外周血及骨髓特点等。应用改良DCEP方案化疗,观察其治疗效果及不良反应。结果 5例患者,男性1例,女性4例,年龄51～75岁。中位随访时间22个月。5例患者均接受了改良DCEP方案化疗,中位疗程数2(2～5)个。部分缓解1例,无进展生存期2个月;微小反应1例,无进展生存期6个月;疾病稳定2例;疾病进展1例。主要的不良反应是消化道症状(4例Ⅱ度)和乏力(3例Ⅱ度),1例发生Ⅳ度骨髓抑制并合并肺部感染。结论改良DCEP方案治疗复发/难治性MM的有效率可,耐受性良好。

Objective To investigate the therapeutic efficacy and adverse reactions of a modified DCEP for relapsed/refractory multiple myeloma （MM）. Methods Enrolled in the study were 5 patients suffering from relapsed/refractory MM, who were treated with modified DCEP in the Department of Geriatric Oncology of the First Affiliated Hospital of Chinese PLA General Hospital. Their clinical data were retrieved, including age, gender, peripheral blood and bone marrow characteristics. The patients were treated with a modified DCEP, and its therapeutic efficacy and adverse reactions were evaluated. Results The 5 patients （1 man and 4 women） were aged from 51 to 75 years. All of them were administered with a modified DCEP with a median course of 2 （range from 2 to 5） and a median follow-up of 22 months. Partial remission was observed in 1 patient with progression-free survival of 2 months, minimal response in 1 patient with progression-free survival of 6 months, stable disease in 2 patients, and progression in 1 patient. The main adverse reactions were gastrointestinal symptoms （grade Ⅱ in 4） and fatigue （grade Ⅱ in 3 ）. One patient developed myelosuppression （grade Ⅳ） complicated with pulmonary infection. Conclusion Modified DCEP is effective and well-tolerated in the patients with relapsed/refractory MM.