目的:观察低剂量反应停(thalidomide)联合地塞米松治疗多发性骨髓瘤(MM)的疗效。方法:18例MM患者中10例为初治患者、8例为复发难治性患者。反应停初始剂量为50～100mg·d-1,每周增加50mg,2周后增加到200mg·d-1;至少每天100mg/d,服用3-6个月。同时联合地塞米松10mg·d-1,连服4天,每月1次。 结果:完全缓解(CR)3例,部分缓解(PR)6例,微缓解(MR)7例,无效2例。无不能耐受的副反应。结论: 地剂量反应停联合地塞米松治疗初发和复发难治性多发性骨髓瘤安全有效。
Citation：
KOU Lan. The Clinical Effectiveness Of Low Dose Thalidomide Combined With Dexamethasone On Multiple Myeloma. West China Medical Journal, 2009, 24(6): 1387-1390. doi:
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- 1. 佘润泉.多发性骨髓瘤治疗进展[J]. 中华血液学杂志,2000,21(11):611-613.
- 2. 复旦大学附属上海市第五人民医院血液科,刘立根,等.沙立度胺治疗MM的临床疗效,2006-08-02.
- 3. SINGHAL S,MEHTA J,DESIKAN R, et al. Antitumor activity of thalidomide in refractory multiple myeloma[J]. N Engl J Med, 1999, 341:1565-1571.
- 4. 张之南.血液病诊断及疗效标准[M].第二版.北京:科学出版社,1998:373-376.
- 5. PARMAN T, WILEY MJ, WELLS PG, et al. Free radialmediated oxidative DNA damage in the mechanism of thalidomide teratogenicity[J]. Nature Medicine,1999,5 (5): 582-585.
- 6. GEITZ H,HANDT S,ZWINGENGER K. Thalidomide selectively modulates the density of cell surface molecules involved in the adhesion cascade[J]. Immunopharmacology, 1996,32:213-221.
- 7. DAVIES FE, RAJE N, HIDESHIMA T, et al. Thalidomide and immunomodulatory derivatives augment natural killer cell cytotoxicity in multiple myeloma[J]. Blood,2001,98(1):210-216.
- 8. HIDESHIMA T, CHAUHAN D, SHIMA Y, et al.Thalidomide and its analogs overcome drug resistance of human multiple myeloma cells to conventional therapy[J].Blood,2000,96:29432950.
- 9. 田炳如,陈幼芬,黄晓烽,等.低剂量反应停联合地塞米松治疗难治性多发性骨髓瘤的临床观察[J].浙江实用医学,2004,9(2):8999〖JY,2〗(收稿日期:20090421).
