A prospective study of lenalidomide monotherapy for relapse after Allo-SCT for multiple myeloma.
A prospective study of lenalidomide monotherapy for relapse after Allo-SCT for multiple myeloma.
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DOI：
10.1038/bmt.2013.219
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发表时间：
2014-04
影响因子：
4.8
通讯作者：
Becker, P. S.
中科院分区：
文献类型：
--
作者：
Bensinger, W. I.;Green, D. J.;Burwick, N.;Becker, P. S.
同种异体干细胞移植（Allo-SCT）可以导致多发性骨髓瘤（MM）患者的长期缓解，尽管其在疾病管理中的总体作用仍存在争议。我们评估了Allo-SCT后进展（PD）或复发的MM患者的来那度胺单药治疗反应和耐受性。18例患者入组，移植后平均12个月（范围3-104）。来那度胺治疗时间为8个月（范围1-57个月）。10例患者需要将剂量从25mg减少到5 - 20mg，中位数为3个周期（范围1-12）；中性粒细胞减少症8例；1个用于血小板减少症，1个用于肌痛和虚弱。严重不良事件N=5，包括H1N1流感（2例）、细菌性肺炎（2例）、发热、肌痛和缺氧。2例患者在服药1个月内发生胃肠道或肝脏GVHD，分别在3个月和5个月时死亡。应答包括CR(5)、VGPR(2)、PR(3)、MR(1)和SD(2)，总应答率（≥PR）为56%。10例患者因帕金森病停止治疗，中位数为8.5（1-43）个月。6例患者死于PD。5例患者在39个月（14-57个月）仍在接受治疗，4例在CR中。来那度胺治疗同种异体细胞移植后MM复发，可使50%的患者延长疾病控制时间（10 - 12个月）。
Allogeneic stem cell transplantation (Allo-SCT) can result in long-term remissions in patients with multiple myeloma (MM), although its overall role in disease management remains controversial. We evaluated lenalidomide monotherapy response and tolerability among patients with MM who progressed (PD) or relapsed after Allo-SCT. Eighteen patients, enrolled a median of 12 months (range 3–104) following transplant. Treatment duration of lenalidomide was 8 months (range 1–57). Ten patients required dose reductions from 25 mg to 5–20 mg at a median of 3 cycles (range 1–12); 8 for neutropenia; 1 for thrombocytopenia, and 1 for myalgias and weakness. Serious adverse events N=5, included H1N1 influenza (2), bacterial pneumonia (2), and fever, myalgia and hypoxia. Two patients died at 3 and 5 months of gastrointestinal or hepatic GVHD occurring within 1 month of dosing. Responses included CR (5), VGPR (2), PR (3), MR (1) and SD (2) for an overall response rate (≥PR) of 56%. Ten patients discontinued therapy for PD a median of 8.5 (1–43) months. Six patients died from PD. Five patients remain on therapy at 39 months (range 14–57), 4 in CR. Lenalidomide for relapse of MM after Allo-SCT can result in extended disease control (>12 months) in 50% of patients.
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