лечение множ. миеломы

[Dr.Vad]

Для всех коллег онкогематологов, кому интересна/полезна будет данная инфо:

ASH: Clarithromycin Augments Response to Dexamethasone With or Without Thalidomide in Advanced Multiple Myeloma

Dexamethasone alone or in combination with low-dose thalidomide is an effective induction therapy for advanced multiple myeloma, and the addition of clarithromycin further improves prognosis, according to a randomised, prospective trial presented here December 9th at the American Society of Hematology 45th Annual Meeting.

The study included 23 patients with advanced myeloma, mostly stage III, and a median age of 62. Induction treatment consisted of pulsed dexamethasone (40 mg/day on Days 1-4, 9-12, and 17-20, every 30 days) with or without low-dose thalidomide (100-200 mg/day). Clarithromycin (550 mg orally twice daily) was also administered to patients who achieved a <50% reduction in paraprotein after 8 weeks of treatment.

Overall, 83% of patients responded to treatment at 8 weeks. Half of the patients showed at least a >50% improvement, and 20% showed a major response (>75% improvement) in the intent-to-treat analysis. No patients showed a complete response.

Almost 40% of patients did not achieve a partial response at 8 weeks, and were therefore given clarithromycin. The addition of clarithromycin resulted in further reduction of tumor mass. By 20 weeks, 55% of these patients had responded.

More corticosteroid-related morbidities were reported with clarithromycin treatment, however. In addition, in the entire cohort, 1 case of grade 4 sepsis/pneumonia and 1 case of grade 3 diverticulitis occurred. Moreover, 4 patients experienced symptoms of deep venous thromboembolism: 3 in the dexamethasone group and 1 in the thalidomide plus dexamethasone group.

[Dexamethsone Alone, or in Combination with Low-Dose Thalidomide as Induction Therapy for Advanced Multiple Myeloma, and the Effect of the Addition of Clarithromycin (Biaxin(TM)) on Response Rate. Interim Results of a Prospective, Sequential, Randomized Trial. Abstract 832]