重组人血管内皮抑素治疗复发难治性多发性骨髓瘤的效果

目的 观察重组人血管内皮抑素(rhES)联合VD方案、常规方案(VCMP方案、VAD方案、MP方案)治疗复发难治性多发性骨髓瘤(RRMM)的临床疗效及安全性.方法 回顾性分析25例接受rhES联合VD方案、22例接受沙利度胺(Tha)联合VD方案、32例接受rhES联合常规方案、32例接受Tha联合常规方案治疗RRMM患者的临床资料,比较四组患者的总反应率(ORR)、无进展生存(PFS)、总生存(OS)及不良反应发生率.结果 rhES联合VD方案组、Tha联合VD方案组的ORR分别为76％(19/25)、59％(13/22),差异无统计学意义(x 2=1.540,P=0.215).rhES联合常规方案组、Tha联合常规方案组的ORR分别为44％(14/32)、34％(11/32),差异无统计学意义(x2=0.591,P=0.442).所有患者中21例死亡,3例失访,中位随访时间7.5个月(0.4～ 27.6个月).rhES联合VD方案组中位PFS和中位OS时间分别为6.9个月(0.5～ 17.3个月)、15.7个月(0.5～27.6个月),Tha联合VD方案组中位PFS和中位OS时间分别为5.2个月(0.5～14.6个月)、13.4个月(0.5～24.9个月),两组PFS差异有统计学意义(P=0.031),OS差异无统计学意义(P=0.129).rhES联合常规方案组中位PFS和中位OS时间分别为5.1个月(0.6 ～ 11.7个月)、6.3个月(0.6～ 18.6个月),Tha联合常规方案组中位PFS和中位OS时间分别为2.7个月(0.4～8.0个月)、3.4个月(0.4～15.7个月),两组PFS差异有统计学意义(P=0.017),OS差异无统计学意义(P=0.123).患者常见的不良反应为骨髓抑制所致的感染和便秘,但组间差异无统计学意义(P＞0.05).结论 rhES可作为RRMM治疗方案的有效补充,可延长PFS,改善患者的生命质量.

Efficacy of recombinant human endostatin on relapsed refractory multiple myeloma

Objective To observe the clinical safety and efficacy of recombinant human endostatin (rhES) in patients with relapsed refractory multiple myeloma (RRMM).Methods The clinical data of 25 cases who accepted rhES combined with VD regimen,22 cases who accepted Tha plus VD regimen,32 cases who accepted rhES combined with routine regimen and 32 cases who received Tha plus routine regimen were analyzed retrospectively.The overall response rate (ORR),progression free survival (PFS),overall survival (OS)and adverse events of the four groups were observed.Results ORRs between rhES combined with VD group (76 ％,19/25) and Tha combined with VD group (59 ％,13/22) and between rhES combined with routine regimen group (44 ％,14/32) and Tha combined with routine regimen group (34 ％,11/32) were no statistical differences (x2 =1.540,P =0.215;x2 =0.591,P =0.442).The median follow-up time was 7.5 months (0.4-27.6 months) with 21 cases died,3 case lost to follow-up.The median PFS and median OS in rhES combined with VD group were 6.9 months (0.5-17.3 months) and 15.7 months (0.5-27.6 months),and those in Tha combined with VD group were 5.2 months (0.5-14.6 months) and 13.4 months (0.5-24.9 months).The difference of PFS between both groups had statistical significance (P =0.031),but the difference of OS had no (P =0.129).The median PFS and median OS in rhES combined with routine regimen group were 5.1 months (0.6-11.7 months) and 6.3 months (0.6-18.6 months),and those in Tha combined with routine regimen were 2.7 months (0.4-8.0 months) and 3.4 months (0.4-15.7 months).The differences of PFS between both groups had statistical significance (P =0.017),but the difference of OS had no (P =0.123).The adverse effects of all patients mainly included infection caused by bone marrow depression and constipation,but there were no significant differences between the groups (P ＞ 0.05).Conclusions rhES may be an effective supplement to the chemotherapy of RRMM,which will prolong the PFS and improve the life quality.