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首页> 外文期刊>Clinical lymphoma & myeloma >Melphalan, prednisone, and lenalidomide for newly diagnosed myeloma: Kinetics of neutropenia and thrombocytopenia and time-to-event results
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Melphalan, prednisone, and lenalidomide for newly diagnosed myeloma: Kinetics of neutropenia and thrombocytopenia and time-to-event results

机译：美法仑，泼尼松和来那度胺用于新诊断的骨髓瘤：中性粒细胞减少和血小板减少症的动力学和事件发生时间

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Background: Initial analysis of the combination melphalan, prednisone, plus lenalidomide (MPR) showed significant antimyeloma activity in patients with untreated multiple myeloma, with neutropenia and thrombocytopenia as the most frequent side effects. This updated analysis reassessed the kinetics of neutropenia and thrombocytopenia as well as the safety and efficacy of MPR. Patients and Methods: A total of 21 patients with newly diagnosed myeloma received melphalan 0.18 mg/kg on days 1-4, prednisone 2 mg/kg on days 1-4, and lenalidomide 10 mg daily on days 1-21 for nine 28-day cycles, followed by maintenance therapy with lenalidomide 10 mg daily on days 1-21. Results: Grade 3/4 neutropenia occurred in 52% of the patients, and granulocyte colonystimulating factor was administered in 43%. The mean neutrophil counts at the start of each MPR cycle, during nadir, and after 6 months of maintenance were 2.69 × 109/L, 1.43 × 109/L, and 2.11 × 109/L, respectively. Grade 3/4 thrombocytopenia occurred in 24% of the patients. Platelet transfusions were required by 1 patient (5%) with a platelet count of 16 × 109/L; however, no thrombocytopenia-associated bleeding was reported. The mean platelet counts at the start of each cycle, during nadir, and after 6 months of maintenance were 174 × 109/L, 121 × 109/L, and 158 × 109/L, respectively. Median follow-up was 29.6 months, median progression-free survival was 28.5 months, and 2-year overall survival was 91%. Conclusion: MPR is a promising regimen with manageable hematologic toxicity.
机译：背景：马法兰，泼尼松和来那度胺（MPR）的组合的初步分析显示，未经治疗的多发性骨髓瘤患者具有明显的抗骨髓瘤活性，其中以中性粒细胞减少和血小板减少为最常见的副作用。这项更新的分析重新评估了中性粒细胞减少和血小板减少的动力学以及MPR的安全性和有效性。患者和方法：共有21例新诊断为骨髓瘤的患者在1-4天接受美法仑0.18 mg / kg，在1-4天接受泼尼松2 mg / kg，在1-21天接受来那度胺10 mg /天，共服用9次28-每天周期，然后在第1-21天每天用来那度胺10 mg维持治疗。结果：52％的患者发生3/4级中性粒细胞减少，43％的患者给予粒细胞集落刺激因子。在每个MPR周期开始时，最低点和维持6个月后，平均嗜中性粒细胞计数分别为2.69×109 / L，1.43×109 / L和2.11×109 / L。 3/4级血小板减少症发生在24％的患者中。 1名患者（5％）需要输注血小板，血小板计数为16×109 / L。然而，没有血小板减少相关的出血报道。在每个周期开始时，最低点和维持6个月后的平均血小板计数分别为174×109 / L，121×109 / L和158×109 / L。中位随访时间为29.6个月，中位无进展生存期为28.5个月，两年总生存率为91％。结论：MPR是一种有希望的治疗血液毒性的方案。

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