来那度胺长期维持治疗对多发性骨髓瘤患者的临床疗效和预后评估

目的:研究多发性骨髓瘤(MM)患者接受来那度胺长期维持治疗的临床疗效及预后评估.方法:选择广州中医药大学第一附属医院血液科2012年-2019年确诊为MM的患者97例,检测并评估其基本临床特征和实验室检查指标.对MM患者进行来那度胺长期维持治疗后,评估其短期和长期临床疗效以及不良反应发生率,并分析影响患者预后的相关因素...

Evaluation of the Clinical Efficacy and Prognosis of Long-Term Maintenance Lenalidomide Therapy in Patients with Multiple Myeloma

Objective:To investigate the clinical efficacy and prognosis of patients with multiple myeloma(MM)treated by long-term maintenance lenalidomide treatment.Methods:A total of 97 patients diagnosed as MM in the Department of Hematology of First Affiliated Hospital of Guangzhou University of Chinese Medicine from 2012 to 2019 were selected,and the basic clinical characteristics and laboratory indicators of the patients were tested and evaluated.After long-term maintenance lenalidomide treatment for patients with MM,the short-term and long-term clinical efficacy and the incidence of adverse reactions were evaluated,and factors affecting the prognosis of the patients were analyzed.Results:Before maintenance treatment,47.42%of the patients(46/97)did not achieve complete remission(CR),among 52.58%(51/97)of CR patients,there were 20.62%of the patients showed minimal residual leukemia(MRD)negative.After lenalidomide maintenance treatment,the patients who did not achieve CR were reduced to 24.74%(24/97),among 75.26%(73/97)of the patients with CR,there were 47.42%of the patients showed MRD negative,the difference showed statistically significant(P<0.001).After maintenance treatment,the median progression-free survival of the patients was 58 months,and the 5-year survival rate was 89.69%.The incidence of adverse reactions was 40.21%(39/97),including neutropenia(31/39,79.49%),fatigue(21/39,53.85%),thrombocytopenia(17/39,43.59%)and gastrointestinal reaction(15/39,38.46%)were the most common.The discontinuation rate was24.74%(24/97),and the median time for discontinuation was 21 months.The main reasons for discontinuation were neutropenia(12/24,50.00%),thrombocytopenia(8/24,33.33%)and gastrointestinal reactions accounted for8.33%(2/24).Old age and positive MRD were the risk factors affecting the prognosis of the patients.The adjusted OR was 1.43(95%CI 1.03-1.76,P=0.034)and 3.78(95%CI 2.56-9.56,P=0.037),respectively.Conclusion:The long-term maintenance lenalidomide treatment shows a good clinical effect on patients with MM,and MRD detection can assist the cilinical judge the prognosis of the patients.During maintenance treatment,the clinical symptoms,especially blood system damage of the patients should be take care,so as to avoid serious adverse reactions.