Cavo M, Galieni P, Tassi C, Gobbi M, Tura S
Institute of Haematology Lorenzo e Ariosto Seràgnoli, University of Bologna, Italy.
Eur J Haematol. 1988 Feb;40(2):168-73. doi: 10.1111/j.1600-0609.1988.tb00816.x.
33 patients with advanced refractory multiple myeloma received a combination of vincristine, cyclophosphamide, carmustine, melphalan and steroids (M-2 protocol). 20 of them had failed prior chemotherapy with alkylating agents and the remaining 13 patients had relapsed after a response to these drugs. An objective tumour cell mass reduction (greater than or equal to 50%) was achieved in 17% of the patients (6% of previously nonresponders and 33% of previously relapsing), while 9 additional patients improved (30-50% tumour reduction), for an overall response rate of 47% (39% for previously nonresponders and 58% for previously relapsing). The median duration of response was 7 months. Thrombocytopenia was the most common toxicity encountered in the study (39% of cases). Our findings indicate that M-2 protocol is an effective salvage treatment for patients who relapse from previous chemotherapy with alkylating agents. In contrast, results in patients who are primarily resistant to these drugs justify the search for different treatment programmes which can produce greater degrees of tumour reduction.
33例晚期难治性多发性骨髓瘤患者接受了长春新碱、环磷酰胺、卡莫司汀、美法仑和类固醇联合治疗（M-2方案）。其中20例患者先前使用烷化剂化疗失败，其余13例患者在对这些药物产生反应后复发。17%的患者实现了客观肿瘤细胞团缩小（大于或等于50%）（先前无反应者中有6%，先前复发者中有33%），另有9例患者病情改善（肿瘤缩小30%-50%），总缓解率为47%（先前无反应者为39%，先前复发者为58%）。缓解的中位持续时间为7个月。血小板减少是该研究中最常见的毒性反应（39%的病例）。我们的研究结果表明，M-2方案对于先前使用烷化剂化疗后复发的患者是一种有效的挽救治疗方法。相比之下，对于那些对这些药物主要耐药的患者，其结果表明有必要寻找能够使肿瘤缩小程度更大的不同治疗方案。
