BiRd方案治疗复发难治多发性骨髓瘤的回顾性研究

OBJECTIVE: To evaluate efficacy of the BiRd regimen, a combination of clarithromycin, lenalidomide, and dexamethasone, in the treatment of patients with relapsed/refractory multiple myeloma (RRMM). METHODS: Patients with RRMM treated with BiRd between September 11, 2013 and August 1, 2016 at six centers were included to evaluate overall survival rate (ORR), clinical benefit rate (CBR), progression-free survival (PFS), overall survival (OS), as well as adverse events. RESULTS: Of 30 patients with RRMM, 27 patients were evaluable, and ORR and CBR were 51.9% (14/27) and 66.7% (18/27) respectively, including 1 sCR (3.7%), 3 CR (11.1%), 3 VGPR (11.1%), and 7 PR (25.6%). In 13 patients with prior Rd, ORR and CBR were 38.5% (5/13) and 61.5% (8/13) respectively, of which 5 patients with ≥MR carried high-risk cytogenetic[(e.g.17p− or t(4;14)] together with at least one of other adverse-prognostic cytogenetic (e.g.13q− and/or 1q21+). In 24 patients with prior bortezomib-based therapy, ORR and CBR were 45.8 and 62.5%, respectively. With a median follow-up time of 14.9 (range 1.0–33.8) months, the median PFS and OS were 12.0 (95%CI 11.6–12.4) and 27.6 (95%CI 15.1–40.1) months, respectively. The BiRd regimen was well tolerated. CONCLUSION: The BiRd regimen is an effective and safety protocol for RRMM, including those carrying high-risk cytogenetic markers.