Palva I P, Ahrenberg P, Ala-Harja K, Almqvist A, Hänninen A, Ilvonen M, Isomaa B, Jouppila J, Järvenpää E, Kilpi H
Hatanpää Hospital, Tampere, Finland.
Eur J Haematol. 1989 Oct;43(4):328-31. doi: 10.1111/j.1600-0609.1989.tb00307.x.
Patients aged 70 yr or older with multiple myeloma were treated, when suitable, according to concurrent trial protocols for younger patients, with the exception that the cytostatic regimen was not allocated at random. Intermittent melphalan and prednisone (MP) was given as the primary treatment to 42 patients and 5-drug combination MOCCA to 68 patients. The groups were comparable with each other, and the distribution of the clinical stages of the patients was similar to the younger patients in concurrent trials. An at least 50% response was achieved in 33% (SE 7.3) with MP and in 75% (SE 5.3) with MOCCA. The median survival times were 39 and 32 months, the relative age-adjusted survival times 45 and 41 months, respectively. Advanced age as such is thus no contraindication for active treatment of myeloma, and in suitable patients the results compare well with those achieved in younger patients.
70岁及以上的多发性骨髓瘤患者,在合适的情况下,按照针对年轻患者的同期试验方案进行治疗,但细胞毒性治疗方案不进行随机分配。42例患者接受间歇美法仑和泼尼松(MP)作为主要治疗,68例患者接受五药联合MOCCA治疗。两组患者相互可比,患者临床分期分布与同期试验中的年轻患者相似。MP组有33%(标准误7.3)达到至少50%的缓解率,MOCCA组为75%(标准误5.3)。中位生存时间分别为39个月和32个月,相对年龄调整后的生存时间分别为45个月和41个月。因此,高龄本身并非骨髓瘤积极治疗的禁忌证,在合适的患者中,治疗结果与年轻患者取得的结果相当。