Bemardeschi P, Dentico P, Rossi S, Fiorentini G, Giustarini G, Turano E
Oncology Unit, S.Giuseppe General Hospital, Empoli, Italy.
J Exp Clin Cancer Res. 2003 Dec;22(4 Suppl):129-33.
Thalidomide is active both as single agent and in combination-therapy against refractory or relapsing multiple myeloma. Eigth patients previously treated were given Thalidomide 100mg/daily plus Dexametasone 40mg/daily for four days each month (Thali-Dexa) and followed for response, prognostic factors and side effects. Two patients had early death (one from massive cerebral ischemic stroke, the other from dementia and progressive renal failure), one patient progressed during Thali-Dexa (thalidomide 200mg) and was rescued with chemotherapy, two patients required increasing thalidomide dosage (to 200 and 400mg, respectively) because of progressive disease, three patients had stable disease remission lasting from 4m+ to 16m+. Thali-Dexa is a useful agent but age and vascular/metabolic diseases may increase the risk of severe side effects. Early decrease in erythrocyte sedimentation rate seems to correlate with better disease control.
沙利度胺作为单一药物以及联合疗法对难治性或复发性多发性骨髓瘤均有活性。对8例先前接受过治疗的患者给予沙利度胺每日100mg加地塞米松每日40mg，每月用药4天（沙利度胺-地塞米松方案），并随访其疗效、预后因素及副作用。2例患者早期死亡（1例死于大面积脑缺血性中风，另1例死于痴呆和进行性肾衰竭），1例患者在沙利度胺-地塞米松方案治疗期间病情进展（沙利度胺200mg），后通过化疗挽救，2例患者因病情进展需要增加沙利度胺剂量（分别增至200mg和400mg），3例患者病情稳定缓解持续4个月以上至16个月。沙利度胺-地塞米松方案是一种有效的治疗方法，但年龄以及血管/代谢疾病可能会增加严重副作用的风险。红细胞沉降率早期下降似乎与更好的疾病控制相关。
