Yuen Hiu Lam Agnes, Low Michael Sze Yuan, Fedele Pasquale, Kalff Anna, Walker Patricia, Bergin Krystal, Coutsouvelis John, Grigoriadis George, Spencer Andrew
a Department of Clinical Haematology , Alfred Health , Melbourne , Australia.
b Monash Haematology, Monash Health , Melbourne , Australia.
Leuk Lymphoma. 2018 Dec;59(12):2842-2846. doi: 10.1080/10428194.2018.1454595. Epub 2018 Apr 4.
There is limited data describing dexamethasone, cyclophosphamide, etoposide, and cisplatin (DCEP) in relapsed refractory multiple myeloma (RRMM). We reviewed 65 patients with RRMM receiving DCEP between 2005 and 2017 in two Melbourne Hospitals. Patients had received a mean of three prior treatment lines (range, 1-11). The mean number of cycles of DCEP was two (range, 1-4). Overall response rate (ORR) was 55% whilst 19% achieved MR and SD. Median overall survival (OS) was 9.6 months. Those bridged to autologous stem cell transplant (ASCT) had significantly improved OS compared to those who were not (median 32.8 vs. 10.7 months, p=.0004). Significant treatment-related mortality (TRM) was observed (9.7%), mostly attributable to grade 3-4 neutropenia and febrile neutropenia. Mandatory use of G-CSF is, therefore, warranted to prevent septic complications. In heavily pretreated RRMM, DCEP is an effective bridge to definitive therapy but in the absence of the latter, its value is questionable.
关于复发难治性多发性骨髓瘤（RRMM）中地塞米松、环磷酰胺、依托泊苷和顺铂（DCEP）的相关数据有限。我们回顾了2005年至2017年期间在墨尔本两家医院接受DCEP治疗的65例RRMM患者。患者之前平均接受过三线治疗（范围为1 - 11线）。DCEP的平均疗程数为两个（范围为1 - 4个）。总缓解率（ORR）为55%，其中19%达到了微小缓解（MR）和疾病稳定（SD）。中位总生存期（OS）为9.6个月。与未接受自体干细胞移植（ASCT）桥接的患者相比，接受桥接的患者OS显著改善（中位值分别为32.8个月和10.7个月，p = 0.0004）。观察到显著的治疗相关死亡率（TRM）（9.7%），主要归因于3 - 4级中性粒细胞减少和发热性中性粒细胞减少。因此，有必要强制使用粒细胞集落刺激因子（G - CSF）以预防感染并发症。在经过大量预处理的RRMM中，DCEP是确定性治疗的有效桥梁，但在缺乏确定性治疗的情况下，其价值值得怀疑。
