Hayashi Tatsuyuki, Yamaguchi Izumi, Saitoh Hiroki, Takagi Masao, Nonaka Yasunobu, Nomura Takeo
Division of Internal Medicine, Tokyo Metropolitan Police Hospital, Tokyo.
Intern Med. 2003 Jul;42(7):605-8. doi: 10.2169/internalmedicine.42.605.
A 64-year-old Japanese man suffering from IgD lambda myeloma and renal failure requiring chronic hemodialysis was treated with thalidomide. Serum IgD concentration was 4,050 mg/dl and myeloma cells constituted 95.6% of nucleated cells in bone marrow at the start of treatment. These parameters improved markedly to 1,590 mg/dl and 22.0%, respectively, in the 4 months immediately prior to his death due to pneumonia. Thalidomide caused peripheral neuropathy and constipation at a dose of 100 mg daily in the first week of treatment, but adverse effects resolved upon dose reduction. Thalidomide represents a valid therapeutic option for some myeloma patients receiving hemodialysis.
一名64岁的日本男性，患有IgD λ型骨髓瘤和肾衰竭，需要长期血液透析，接受了沙利度胺治疗。治疗开始时，血清IgD浓度为4050mg/dl，骨髓瘤细胞占骨髓有核细胞的95.6%。在他因肺炎去世前的4个月里，这些参数分别显著改善至1590mg/dl和22.0%。沙利度胺在治疗的第一周每天服用100mg时引起了周围神经病变和便秘，但在减量后不良反应消失。沙利度胺是一些接受血液透析的骨髓瘤患者的有效治疗选择。
