以达雷妥尤单抗为基础的联合方案治疗多发性骨髓瘤的效果及安全性

Efficacy and safety of daratumumab-based combined regimens for treatment of multiple myeloma

目的探讨达雷妥尤单抗治疗多发性骨髓瘤(MM)的安全性及有效性。方法回顾性分析2021年6月至12月济宁医学院附属医院接受达雷妥尤单抗单独或联合化疗方案治疗的19例MM患者临床资料,其中单独使用达雷妥尤单抗2例,达雷妥尤单抗联合来那度胺+地塞米松(DRD)方案6例,联合脂质体多柔比星+地塞米松(DVD)方案1例,联合地塞米松+环磷酰胺+依托泊苷+顺铂(DECP)方案2例,联合伊沙佐米+地塞米松(ID)方案3例,联合硼替佐米+地塞米松(BD)方案2例,联合地塞米松(DD)方案3例,分析疗效和不良反应的发生情况。结果19例患者中完全缓解(CR)8例,非常好的部分缓解(VGPR)1例,部分缓解(PR)5例,疾病稳定(SD)1例,疾病进展(PD)4例,总反应率(ORR)73.7%(14/19)。中位无进展生存时间10.42个月(95%CI 8.04~12.79个月),中位总生存时间52.06个月(95%CI 37.85~66.27个月)。治疗中出现的不良反应主要有3级中性粒细胞减少3例,3级淋巴细胞减少3例,2级贫血5例,2级恶心、呕吐7例,输液相关不良反应7例。结论以达雷妥尤单抗为基础的联合化疗方案治疗MM患者可取得较好的疗效,安全性和耐受性良好。

Objective To evaluate the safety and efficacy of daratumumab in the treatment of multiple myeloma(MM).Methods The clinical data of 19 MM patients treated with daratumumab alone or in combination with chemotherapy regimens from June 2021 to December 2021 in the Affiliated Hospital of Jining Medical College were retrospectively analyzed,of which 2 patients received daratumumab alone,6 cases received daratumumab combined with lenalidomide+dexamethasone(DRD)regimen,1 case received daratumumab combined with liposomal doxorubicin+dexamethasone(DVD)regimen,2 case received daratumumab combined with dexamethasone+cyclophosphamide+etoposide+cisplatin(DECP)regimen,3 cases received daratumumab combined with isazomib+dexamethasone(ID)regimen,2 cases received daratumumab combined with bortezomib+dexamethasone(BD)regimen,and 3 cases received daratumumab combined with dexamethasone(DD)regimen.The efficacy and incidence of adverse effects were analyzed.Results Among the 19 patients,8 had complete remission(CR),1 had very good partial remission(VGPR),5 had partial remission(PR),1 had stable disease(SD),and 4 had progressive disease(PD).The overall response rate(ORR)was 73.7%(14/19).The median progression-free survival(PFS)time was 10.42 months(95%CI 8.04-12.79 months)and the median overall survival(OS)time was 52.06 months(95%CI 37.85-66.27 months).The main adverse reactions during treatment were grade 3 neutropenia in 3 cases,grade 3 lymphopenia in 3 cases,grade 2 anemia in 5 cases,grade 2 nausea and vomiting in 7 cases,and infusion-related adverse reactions in 7 cases.Conclusions Daratumumab-based chemotherapy regimens for the treatment of MM patients can achieve great efficacy with good safety and tolerability.