Dispenzieri Angela, Lacy Martha Q, Rajkumar S Vincent, Geyer Susan M, Witzig Thomas E, Fonseca Rafael, Lust John A, Greipp Philip R, Kyle Robert A, Gertz Morie A
Division of Hematology, Department of Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Amyloid. 2003 Dec;10(4):257-61. doi: 10.3109/13506120309041743.
Treatments effective against multiple myeloma may be useful in primary systemic amyloidosis (AL). Thalidomide is active in myeloma. Results of the first 12 patients enrolled on a phase II trial of thalidomide for AL are presented. Progressive edema, cognitive difficulties, and constipation occurred in approximately 75%; dyspnea, dizziness and rash in 50%. Five developed progressive renal insufficiency. Deep venous thrombosis and syncope each occurred in two. Median time on the study was 72 days, range was 25 to 333 days. All 12 have withdrawn from the study (side-effects, 6; progression, 4; and death, 2 patients). AL patients do not tolerate high dose thalidomide.
对多发性骨髓瘤有效的治疗方法可能对原发性系统性淀粉样变性（AL）有用。沙利度胺对骨髓瘤有活性。本文介绍了首批12例入组沙利度胺治疗AL的II期试验患者的结果。约75%的患者出现进行性水肿、认知困难和便秘；50%的患者出现呼吸困难、头晕和皮疹。5例出现进行性肾功能不全。深静脉血栓形成和晕厥各有2例发生。研究的中位时间为72天，范围为25至333天。所有12例患者均已退出研究（6例因副作用，4例因病情进展，2例死亡）。AL患者不能耐受高剂量沙利度胺。
