Sahebi F, Spielberger R, Kogut N M, Fung H, Falk P M, Parker P, Krishnan A, Rodriguez R, Nakamura R, Nademanee A, Popplewell L, Frankel P, Ruel C, Tin R, Ilieva P, Forman S J, Somlo G
Division of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA 910010, USA.
Bone Marrow Transplant. 2006 May;37(9):825-9. doi: 10.1038/sj.bmt.1705339.
Although autologous stem cell transplant is an effective therapy for patients with multiple myeloma and extends progression-free survival (PFS) and overall survival (OS), patients show a continued pattern of recurrent disease. Twenty-nine patients were enrolled in a phase II study investigating the tolerability and efficacy of maintenance thalidomide following single autologous peripheral blood stem cell transplant. Six to eight weeks after transplant, patients were started on maintenance thalidomide at 50 mg a day. The dose was gradually escalated to a target dose of 400 mg a day and continued until disease progression or 6 months after achieving complete remission (CR) for a maximum total duration of 18 months. At 6 months, 13 patients (45%) achieved CR or near complete remission (positive immunofixation without any evidence of disease). The estimated 2-year OS was 83% and PFS was 49%. Median tolerated dose of thalidomide was 200 mg a day. In conclusion, thalidomide as maintenance therapy is feasible and may improve outcome after single autologous stem cell transplant.
尽管自体干细胞移植是治疗多发性骨髓瘤患者的有效疗法，可延长无进展生存期（PFS）和总生存期（OS），但患者仍表现出疾病复发的持续模式。29例患者参加了一项II期研究，该研究旨在调查单次自体外周血干细胞移植后使用沙利度胺进行维持治疗的耐受性和疗效。移植后6至8周，患者开始服用沙利度胺进行维持治疗，剂量为每日50毫克。剂量逐渐递增至目标剂量每日400毫克，并持续至疾病进展或达到完全缓解（CR）后6个月，最长总疗程为18个月。6个月时，13例患者（45%）达到CR或接近完全缓解（免疫固定阳性但无任何疾病证据）。估计2年总生存率为83%，无进展生存率为49%。沙利度胺的中位耐受剂量为每日200毫克。总之，沙利度胺作为维持治疗是可行的，可能会改善单次自体干细胞移植后的疗效。
