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[来那度胺/硼替佐米/地塞米松治疗新诊断多发性骨髓瘤100例连续病例的单中心回顾性分析]

[A single-center retrospective analysis of 100 consecutive cases treated with lenalidomide/bortezomib/dexamethasone in newly diagnosed multiple myeloma].

作者信息

Wang W X, Bi J Y, Wen L, Duan W B, Liu Y, Wang F R, He Q, Lu J

机构信息

Department of Hematology, Peking University People's Hospital & Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China.

Department of Hematology, Peking University People's Hospital & Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China Collaborative Innovation Center of Hematology, Suzhou 215006, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2022 May 1;61(5):531-536. doi: 10.3760/cma.j.cn112138-20211105-00776.

Abstract

To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM). A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People's Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis. The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively (=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively (=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.

摘要

探讨来那度胺联合硼替佐米及地塞米松(RVD)方案治疗初诊多发性骨髓瘤(NDMM)患者的疗效及安全性。回顾性分析2016年8月至2020年9月于北京大学人民医院接受RVD方案治疗的100例连续NDMM患者,内容包括疗效、药物毒性、随访及生存情况,并进行亚组分析。中位随访时间为19.5(2.0 - 57.0)个月。接受RVD方案后行自体干细胞移植(ASCT)的患者,客观缓解率(ORR)/完全缓解+严格完全缓解(CR + sCR)/≥非常好的部分缓解(VGPR)率分别为100%、73.3%(33/45)、95.6%(43/45)。54例未接受移植的患者,ORR/CR + sCR/≥VGPR率分别为79.6%(43/54)、18.5%(10/54)、51.9%(28/54)。生存分析显示,移植组和非移植组患者的2年无进展生存率(PFS)分别为84.5%和70.9%(P = 0.102)。移植组和非移植组患者的2年总生存率(OS)分别为100%和80.8%(P = 0.003)。常见血液学不良事件(AE)为血小板减少(33%)和中性粒细胞减少(25%)。肝功能异常(43%)和周围神经病变(24%)更多被视为非血液学AE。RVD作为一线方案在中国初诊MM患者中具有高效的缓解率及可接受的安全性。

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