Boulin M, Blanchet F, Isambert N, Solary E, Solier S, Collin B, Pernot C, Durnet-Archeray M J
Service Pharmacie, C.H.U. Bocage, Boulevard Maréchal De Lattre De Tassigny, Dijon, France.
Therapie. 2002 Nov-Dec;57(6):524-9.
It was shown in 1999 thalidomide could induce a therapeutic response in patients with refractory multiple myeloma. Between March 2000 and January 2002, we treated 21 patients with refractory multiple myeloma with thalidomide (Thalidomide) at initial dose of 400 mg a day. Response rate (Intergroupe Francophone du Myélome criteria) was 33 percent and median progression-free survival estimated to 15 months. All patients suffered from drowsiness and constipation requiring lowest doses. Five patients developed a sensitive neuropathy. Eight refractory patients were treated by a combination of their prior maximally tolerated dose of thalidomide and monthly dexamethasone (Soludécadron) alone (n = 4) or associated to cyclophosphamide (Endoxan) and étoposide (Etopophos) (n = 4). Six patients on 8 were responders. Our results suggest that the combination thalidomide/dexamethasone should be compared to thalidomide alone in a prospective, randomized study in patients with refractory multiple myeloma.
1999年有研究表明沙利度胺可使难治性多发性骨髓瘤患者产生治疗反应。2000年3月至2002年1月期间，我们用沙利度胺（反应停）以每日400毫克的初始剂量治疗了21例难治性多发性骨髓瘤患者。缓解率（按照法语国家骨髓瘤协作组标准）为33%，中位无进展生存期估计为15个月。所有患者均出现嗜睡和便秘，需要使用最低剂量。5例患者出现感觉性神经病变。8例难治性患者接受了其先前最大耐受剂量的沙利度胺联合每月一次地塞米松（氟美松）单独治疗（4例）或联合环磷酰胺（癌得星）和依托泊苷（威猛）治疗（4例）。8例患者中有6例有反应。我们的结果提示，在一项针对难治性多发性骨髓瘤患者的前瞻性随机研究中，应将沙利度胺/地塞米松联合方案与单用沙利度胺进行比较。
