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

摘要

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.%　　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(2 mg,1次/d)、CTX(0.2 g,1次/d)、DEX (10 mg 1次/12h)静脉滴注,连续应用5 d,21 d为一疗程；同时给予沙利度胺口服,起始剂量为100 mg/d,1周后逐步加量并调整至100~200 mg/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.