MPT治疗原发性巨球蛋白血症临床疗效观察(1)
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2011年1月15日
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[摘要] 目的：观察MPT治疗原发性巨球蛋白血症(WM)的临床疗效。方法：10例WM患者均应用MPT方案，美发仑片4 mg/(m2·d)，分3次口服，口服7 d，泼尼松片1 mg/(kg·d)，每日1次口服，口服7 d，沙利度胺片100 mg/d，睡前顿服，持续服用6个月，不能耐受的给予50 mg/次，早晚服用。4周1个疗程，应用6个疗程后评价疗效。结果：完全缓解(CR)3例，部分缓解(PR)4例，未缓解(NR)3例，总有效率为70%。所有患者治疗前血红蛋白、血清IgM、骨髓淋巴样浆细胞比例较治疗前均有明显改善(P<0.05)。5例出现便秘，2例四肢麻木，其余患者未见其他明显不良反应发生。结论：MPT方案治疗WM疗效明显、患者耐受性较好、副作用小，易于推广应用。
[关键词] 原发性巨球蛋白血症；MPT；临床疗效观察
[中图分类号] R55 [文献标识码]A[文章编号]1674-4721(2011)01(b)-028-02
Clinical observation of MPT treatment of primary macroglobulinemia
ZHAO Hongmian, WU Dapeng
(Department of Hematology, Huaihe Hospital of Henan University, Henan Province, Kaifeng 475000, China)
[Abstract] Objective: To observe the clinical efficacy of MPT treatment of primary macroglobulinemia (WM). Methods: MPT program were applied in 10 patients with WM, Meifalun film 4 mg/(m2·d), three times orally, oral 7 days, prednisone tablets 1 mg/(kg·d), orally once a day, 7 days of oral thalidomide tablets 100 mg, dayton clothing before going to bed, continuing to take for 6 months, patient who can not tolerate could be given 50 mg/times, sooner or later take. 4 weeks a course, the effect was evaluated after application of 6 courses. Results: Complete remission (CR) 3 patients and partial remission (PR) 4 patients, no remission(NR) 3 cases, the total efficiency was 70%. Hemoglobin, serum IgM, the proportion of bone marrow lymphoid plasma cells in all patients before treatment, were significantly improved compared with before treatment (P<0.05). 5 cases of constipation, numbness of the limbs in 2 cases, other patients with no significantly adverse reactions. Conclusion: The efficacy of MPT in the treatment of WM is well tolerated in patients, side effects, easy application.
[Key words] Primary macroglobulinemia; MPT; Clinical efficacy
原发性巨球蛋白血症，即华氏巨球蛋白血症(waldenstrtim's macroglob-ulinemia，WM)，又称淋巴浆细胞淋巴瘤，发病多见于老年人，多在50岁以上，临床表现常不特异，临床上容易误诊为为原发性血小板减少性紫癜、淋巴瘤、慢性淋巴细胞白血病、多发性骨髓瘤等疾病，早期常无不适或乏力，体重减轻，病情常为进行性发展为贫血、出血(常见皮肤紫癜、鼻衄)，淋巴结、肝、脾大等，严重者出现瘫痪，意识障碍甚至昏迷等。本病少见，但近几年来发病率有升高趋势。而且随着新药的研究，治疗方法也愈来愈多，如蛋白酶体抑制剂-硼替唑咪，核苷类似物氟达拉滨,与克拉屈滨单克隆抗体美罗华与依帕珠单抗，高剂量化疗及干细胞移植，血浆置换等，但由于以上几种方法价格昂贵，多数患者不易接受，而且该病常见于老年人,高剂量化疗及干细胞移植开展也很困难。烷化剂为基础的治疗包括单用烷化剂或联合类固醇用于WM的初始治疗已广泛应用。大量临床及实验研究已证明其疗效确切 ......
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