Haematologica:新发轻链淀粉样变性患者采用来那度胺/美法仑/地塞米松治疗效果如何?

2017-05-29 xing.T MedSci原创

由此可见,该研究可以得到以下结论,即采用来那度胺、美法仑和地塞米松治疗在轻链淀粉样变性患者达到血液学缓解、器官反应和移植合适者连续长期生存方面是非常有效的。然而,3个药物治疗方案的主要问题是毒性和耐受性,严格的监测程序是必要的并且足以避免严重的毒性反应发生。

轻链淀粉样变性化疗的目的是使血清中游离轻链正常化,从而使大多数反应患者的器官功能得到改善或至少稳定。近日,血液病领域权威杂志Haematologica上发表了一篇研究文章,研究人员对50例未经治疗的且不适合高剂量治疗死亡患者进行了一项前瞻性单中心2期试验。

该研究的治疗方案包括6个疗程的口服来那度胺、美法仑和地塞米松每4周。治疗6个月后,研究人员发现9例(18%)患者达到完全缓解,16例(32%)患者达到了非常好的部分缓解,另有9例(18%)患者部分缓解。

总体而言,研究人员在24例(48%)患者中观察到了器官反应。血液系统和心脏毒性是主要的不良事件。在3个月的死亡率较低为4%(n=2),尽管纳入了36%的心脏阶段为梅奥3期的患者(n=18)。中位随访50个月后,中位总生存期和无事件生存期分别为67.5个月和25.1个月。

由此可见,该研究可以得到以下结论,即采用来那度胺、美法仑和地塞米松治疗在轻链淀粉样变性患者达到血液学缓解、器官反应和移植合适者连续长期生存方面是非常有效的。然而,3个药物治疗方案的主要问题是毒性和耐受性,严格的监测程序是必要的并且足以避免严重的毒性反应发生。

原始出处:

Ute Hegenbart, et al. Lenalidomide/Melphalan/Dexamethasone In Newly Diagnosed Patients With AL Amyloidosis: Results Of A Prospective Phase 2 Study With Long-Term Follow-Up. Haematologica. 2017. http://www.haematologica.org/content/early/2017/05/11/haematol.2016.163246

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    2017-05-31 fengyi812
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  8. 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    2017-05-31 huangdf
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1463532, encodeId=41861463532c3, content=<a href='/topic/show?id=7d27381288e' target=_blank style='color:#2F92EE;'>#变性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38128, encryptionId=7d27381288e, topicName=变性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f69f6545041, createdName=huangdf, createdTime=Wed May 31 12:30:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204784, encodeId=feb5204e846e, content=认真学习,不断进步,把经验分享给同好。点赞了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Wed May 31 11:33:28 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204487, encodeId=f01320448e49, content=继续学习中谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Tue May 30 21:33:11 CST 2017, time=2017-05-30, status=1, ipAttribution=)]
    2017-05-31 ylzr123

    认真学习,不断进步,把经验分享给同好。点赞了!

    0

  10. 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createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Wed May 31 11:33:28 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204487, encodeId=f01320448e49, content=继续学习中谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Tue May 30 21:33:11 CST 2017, time=2017-05-30, status=1, ipAttribution=)]
    2017-05-30 往日如昨

    继续学习中谢谢

    0