Maintenance, therapy with thalidomide improves survival in patients with multiple myeloma
Maintenance, therapy with thalidomide improves survival in patients with multiple myeloma
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DOI：
10.1182/blood-2006-05-022962
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发表时间：
2006-11-15
期刊：
影响因子：
20.3
通讯作者：
Facon, Thierry
中科院分区：
文献类型：
--
作者：
Attal, Michel;Harousseau, Jean-Luc;Facon, Thierry
较新的化疗方案以及高剂量化疗增加了骨髓瘤的缓解率。然而，这些治疗并不是治愈性的。现在需要有效的维持战略来延长反应的持续时间。我们进行了一项沙利度胺和帕米膦酸盐维持治疗的随机试验。在高剂量治疗后两个月，597名年龄小于65岁的患者被随机分配到不接受维持治疗（A组）、帕米膦酸盐（B组）或帕米膦酸盐加沙利度胺（C组）。A组、B组和C组分别有55%、57%和67%的患者达到完全缓解或非常好的部分缓解（P = 0.03）。随机化后3年无事件生存率A组为36%，B组为37%，C组为52%（P <0.009）。A组、B组和C组的4年诊断后生存率分别为77%、74%和87%（P <0.04）。A组、B组和C组发生骨骼事件的患者比例分别为24%、21%和18%（P = 0.4）。沙利度胺是治疗多发性骨髓瘤的有效维持疗法。帕米膦酸盐维持治疗不能降低骨事件的发生率。
Newer chemotherapeutic protocols as well as high-dose chemotherapy have increased the response rate in myeloma. However, these treatments are not curative. Effective maintenance strategies are now required to prolong the duration of response. We conducted a randomized trial of maintenance treatment with thalidomide and pamidronate. Two months after high-dose therapy, 597 patients younger than age 65 years were randomly assigned to receive no maintenance (arm A), pamidronate (arm B), or pamidronate plus thalidomide (arm C). A complete or very good partial response was achieved by 55% of patients in arm A, 57% in arm B, and 67% in arm C (P = .03). The 3-year postrandomization probability of event-free survival was 36% in arm A, 37% in arm B, and 52% in arm C (P < .009). The 4-year postdiagnosis probability of survival was 77% in arm A, 74% in arm B, and 87% in arm C (P < .04). The proportion of patients who had skeletal events was 24% in arm A, 21% in arm B, and 18% in arm C (P = .4). Thalidomide is an effective maintenance therapy in patients with multiple myeloma. Maintenance treatment with pamidronate does not decrease the incidence of bone events.