演題詳細

一般口演 / Oral Session

一般口演 86 (Oral Session 86) :骨髄腫:再発難治・治療

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日程
2013年10月13日(日)
時間
08:45 - 09:45
会場
第10会場 / Room No.10 (ロイトン札幌 20F パールホールAB)
座長・司会
伊藤 薫樹 (Shigeki Ito):1
1:岩手医科大学 血液・腫瘍内科
 
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Addition of oral cyclophosphamide is effective for myeloma refractory to lenalidomide/dexamethasone

演題番号 : OS-3-74

加藤 浩貴 (Hiroki Kato):1、大西 康 (Yasushi Onishi):1、大橋 圭一 (Keiichi Ohashi):1、近藤 愛子 (Aiko Kondou):1、長谷川 慎 (Shin Hasegawa):1、沖津 庸子 (Yoko Okitsu):1、勝岡 優奈 (Yuuna Katsuoka):1、福原 規子 (Noriko Fukuhara):1、藤原 亨 (Toru Fujiwara):1、亀岡 淳一 (Junichi Kameoka):1、石澤 賢一 (Kenichi Ishizawa):1、高川 真徳 (Masanori Takagawa):2、張替 秀郎 (Hideo Harigae):1

1:Department of Hematology and Rheumatology, Tohoku University Hospital、2:Department of Internal Medicine, Japanese Red Cross Ishinomaki Hospital

 

Lenalidomide (Len) and dexamethasone (Dex) is an effective treatment not only for newly-diagnosed multiple myeloma, but also for relapsed myeloma. In the past studies of Len/Dex for relapsed myeloma, the time to progression is about 11 months. After becoming resistant to Len/Dex, addition of cyclophosphamide (Cy) to Len/Dex is one option as salvage treatment. We conducted a retrospective analysis to evaluate the efficacy and toxicity when low-dose oral Cy was used in combination with low-dose Len/Dex for Len/Dex-refractory myeloma and plasma cell leukemia (PCL). Five myeloma and 1 plasma cell leukemia patients with a median age of 67 years (range: 43-78 years) received 28-day cycles of continuous low-dose oral Cy (50-100 mg, days 1-21), Len (5-10 mg, days 1-21), and Dex (20-40 mg/week). A median 4 (range: 3-8) lines of treatment were given previously, including high-dose melphalan in 4 patients, and all patients received a median 12 cycles (range: 4-18) of Len/Dex before the treatment of Cy/Len/Dex (CLD). M-protein was decreased in 5 of 6 patients, and 3 patients had partial response and 2 had stable disease. Two of these 5 patients had disease progression after 15 and 8 cycles of CLD. To date, the other 3 patients have received 15, 14, and 4 cycles of CLD without progression. Grade 3 and 4 neutropenia were observed in 3 and 2 patients, respectively. There was no treatment-related death. The addition of low-dose oral Cy to Len/Dex is a promising option for relapsed/refractory myeloma and PCL. Prospective study is needed to evaluate the combination of CLD.

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