Morris T C M, Kettle P J, Drake M, Jones F C G, Hull D R, Boyd K, Morrison A, Clarke P, O'Reilly P, Quinn J
Haematology Department, Belfast City Hospital, Belfast, UK.
Br J Haematol. 2008 Nov;143(3):349-54. doi: 10.1111/j.1365-2141.2008.07360.x. Epub 2008 Aug 28.
A combination of clarithromycin, low dose of thalidomide and low dose dexamethasone was used in a phase II study to treat patients with relapsed and refractory myeloma. Thirty patients received clarithromycin 250 mg twice daily and thalidomide 50 mg at night on an ongoing basis with 4-d pulses of 10 mg dexamethasone given monthly. Eight patients had permitted escalation of thalidomide dosage up to 200 mg daily. The combination was well tolerated and could be given to elderly, infirm and severely cytopenic patients. Response rates were high, with 89% achieving at least 50% reduction in paraprotein and a 96% overall response rate. Although clarithromycin has only minimal anti-myeloma properties when used as a single agent, its combination with thalidomide and dexamethasone appears very effective, allowing these to be used in lower and more tolerable doses with good clinical effects.
在一项II期研究中，使用克拉霉素、低剂量沙利度胺和低剂量地塞米松联合治疗复发难治性骨髓瘤患者。30例患者持续每日两次接受250mg克拉霉素治疗，每晚服用50mg沙利度胺，并每月给予4天的10mg地塞米松脉冲治疗。8例患者获准将沙利度胺剂量增至每日200mg。该联合方案耐受性良好，可用于老年、体弱和严重血细胞减少的患者。缓解率很高，89%的患者副蛋白至少降低50%，总缓解率为96%。尽管克拉霉素作为单一药物使用时仅有最小的抗骨髓瘤特性，但其与沙利度胺和地塞米松联合使用似乎非常有效，使这些药物能够以更低且更易耐受的剂量使用并产生良好的临床效果。
