Steiner Normann, Nachbaur David, König Paul, Willenbacher Wolfgang, Gunsilius Eberhard
Department of Internal Medicine V (Hematology and Medical Oncology), Innsbruck Medical University, Innsbruck, Austria Laboratory of Tumor Biology and Angiogenesis, Innsbruck Medical University, Innsbruck, Austria.
Department of Internal Medicine V (Hematology and Medical Oncology), Innsbruck Medical University, Innsbruck, Austria.
Anticancer Res. 2015 Apr;35(4):2165-8.
Prognosis of patients with multiple myeloma (MM) has substantially improved in recent years due to the incorporation of novel drugs into their treatment. However, older drugs should be kept in mind when modern drugs have failed.
We report on a 62-year-old female patient with high-risk, refractory light-chain myeloma who initially presented with acute renal failure and was consecutively treated with six different therapies without achievement of sustained disease control. Therapy of cyclophosphamide orally at 50 mg/day (100 mg twice a week) and dexamethasone at 24 mg once weekly was initiated, resulting in a very good partial response which was maintained for more than 21 months. Low-dose cyclophosphamide in combination with dexamethasone was well-tolerated and no significant hematological or nonhematological side-effects were noted.
We suggest that older drugs should be kept in mind as treatment options for patients with disease refractory to multiple therapies, including novel agents.
近年来，由于新型药物被纳入多发性骨髓瘤（MM）患者的治疗方案，其预后有了显著改善。然而，当现代药物治疗失败时，应考虑使用 older drugs。
我们报告了一名62岁的高危、难治性轻链骨髓瘤女性患者，该患者最初表现为急性肾衰竭，先后接受了六种不同的治疗方案，但均未实现持续的疾病控制。开始口服环磷酰胺，剂量为50mg/天（每周两次，每次100mg），地塞米松每周一次，剂量为24mg，治疗后获得了非常好的部分缓解，并维持了超过21个月。低剂量环磷酰胺联合地塞米松耐受性良好，未观察到明显的血液学或非血液学副作用。
我们建议，对于多种治疗方案（包括新型药物）难治的患者，应考虑将 older drugs 作为治疗选择。
