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买21颗药花了5.9万元，母亲去世后还有18颗药没吃温州都市报：退药不成威胁放“炸弹” 一百多人被紧急疏散龙湾男子张某因涉嫌投放虚假危险物质罪昨天被提起公诉
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　　今日打油诗
　　电梯前面有&炸弹&？一百多人被疏散。纠纷全因退药起，如此胡闹须法办！
　　龙湾男子张某为了退药费，与医院发生纠纷，竟扬言要炸掉医院，并将一疑似爆炸物遗留在医院。为排除疑似爆炸物，公安机关出动了大量警力，院方紧急疏散了100多名医务人员及病人。昨天，瓯海区检察院表示，张某因涉嫌投放虚假危险物质罪被该院提起公诉。其中详情，且听老师伯慢慢道来：
　　今年1月29日早上6时许，温医大附一院新院区清洁工老王在4号楼打扫卫生时发现，电梯口有一个黑色袋子包裹着的小纸板箱。到了9时许，黑袋子还放在那里，于是老王将其拿到了护士台。打开后发现，里面是一个用透明胶带封着的纸板箱，箱子一侧的小孔里露出一段导火线。后来有人认出，一病患家属前一天曾带着类似的箱子来过。
　　因怀疑可能系爆炸物，院方立即报警。公安人员到达现场后，院方对该病区49张病床的病人、陪护、医护人员共100多人进行了紧急疏散。后公安人员出动排爆机器人，将疑似炸弹排除。
　　这纸箱是谁放的？里面装的是什么？放这个纸箱的是龙湾男子张某，今年44岁。据张某交代，他按照医生的推荐，为患重病的母亲购买了一盒&雷那度胺&，花了5.9万元，里面共有21颗药。吃了3天药后，母亲去世了。办完母亲的后事，张某准备把剩下的18颗药退掉，并因此多次到医院。
　　1月28日上午，张某与嫂子再次来到医院，并随身携带了一个纸箱。张某称里面只是些垃圾，其中有一个八宝粥盒子、一瓶矿泉水、还有一个空香烟盒子，至于箱子里的导火线，张某辩解说母亲刚过世，可能是小孩子放鞭炮的时候留下的。他说带纸箱过来是准备放垃圾用的，后由嫂子保管时遗忘在医院。回家途中，嫂子告知他装纸箱的黑色塑料袋落在医院了，张某表示东西不值钱遂没有去取回。
　　据院方介绍，去年11月份，该院收治了一名多发性骨髓瘤晚期病人，即张某的母亲。在治疗期间，主治医生曾建议病人家属到院外一指定药店购买一种治疗骨髓瘤的药物，叫&雷那度胺&，张某母亲吃了三天药,后死亡。张某多次到医院要求退还剩余的药，并怀疑医院收了好处费不肯退钱。其间，张某多次发短信对主治医生进行威胁。1月28日，张某再次来到医院找主治医生要求退钱，并声称要将医院炸掉。院方解释，病人服用的药物是一种进口处方药，需凭医生处方才能购买，且只有该药店有售，并没有收取好处费。
　　瓯海区检察院审查后认为，张某在公共场所投放虚假的爆炸性物质，致公安机关采取紧急疏散、紧急排爆等措施，严重扰乱社会秩序，其行为已触犯《刑法》，涉嫌投放虚假危险物质罪，故依法提起公诉。
　　瓯海区法院将择日开庭审理该案。
　　瓯文吴祖坚
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【资讯翻译】雷那度胺联合美罗华治疗套细胞淋巴瘤前景喜人
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【认 领 须 知】1、认领翻译的战友请跟帖注明“认领本文翻译，48小时内未完成，请其他战友认领！”2、请根据自己专业背 景选择认领，如使用翻译软件翻译，被发现者扣分1-2分3、经常认领而不能及时提供优质稿件者将被列入黑名单，取消认领资格，请大家注意！4、翻译时请参照版规： 5、在首位认领战友未超过规定时间的其他任何认领属违规认领，将不会给予丁当或加分！6、翻译完成后加分（或丁当）的时限为三日，请耐心等待，若超过时限未加者可进行申诉：7、本文题目仅供译者参考，篇幅较长者可申请适当延时8、翻译前请查一下有无重复帖9、为保证翻译质量，每人每天最多只能认领两篇原文链接：/ViewNews.aspx?nid=34014Lenalidomide Plus Rituximab Appears Promising as First-Line Therapy for Mantle Cell Lymphoma Mantle cell lymphoma, which is characterized by CD5-positive, CD23-negative follicular mantle B cells with t(11:14)(q13;q32) translocation and cyclin D1 overexpression, is generally incurable and associated with a median survival of between 4 and 5 years. Although front-line treatment for mantle cell lymphoma is not standardized, it usually includes cytotoxic chemotherapy, which can be clinically challenging for patients, who are usually older and may find the side effects from high-dose chemotherapy and hematopoietic cell transplantation difficult to manage.To determine whether the initial management of mantle cell lymphoma using biologic agents might offer effective disease control and fewer side effects than chemotherapy approaches, a phase II study by Ruan et al was launched to evaluate the efficacy and safety of the combination of lenalidomide (Revlimid) and rituximab (Rituxan) as induction and maintenance therapy in patients with previously untreated mantle cell lymphoma. The study was published in .Study MethodologyThe researchers conducted a single-group, multicenter phase II trial with induction and maintenance phases. A total of 38 patients with untreated mantle cell lymphoma were enrolled in the study from July 2011 through April 2014. The median age was 65, all patients had stage III or IV disease, and the proportions of participants with low-risk, intermediate-risk, and high-risk disease at baseline were similar: 34%, 34%, and 32%, respectively.During the induction phase, lenalidomide was administered at a dose of 20 mg daily on days 1 through 21 of every 28-day cycle for 12 the dose was escalated to 25 mg daily after the first cycle if no dose-limiting adverse events occurred during the first cycle and was reduced to 15 mg daily during the maintenance phase. Rituximab was administered once weekly for the first 4 weeks and then once every other cycle until disease progression.The primary endpoint was overall response rate. Secondary endpoints included outcomes related to safety, survival, and quality of life.Study FindingsAt a median follow-up of 30 months (through February 2015), the overall response rate among evaluable participants was 92% (95% confidence interval [CI] = 78%–98%), and the complete response rate was 64% (95% CI = 46%–79%); median progression-free survival had not been reached. The 2-year progression-free survival was estimated to be 85% (95% CI = 67%–94%), and the 2-year overall survival 97% (95% CI = 79%–99%). A response to treatment was associated with improvement in quality of life.The most common grade 3 or 4 adverse events were neutropenia (50%), rash (29%), thrombocytopenia (13%), an inflammatory syndrome, or “tumor flare” (11%), anemia (11%), serum sickness (8%), and fatigue (8%).Preserving Quality of Life“For patients, their quality of life was preserved or improved, and that’s a huge step up from regular chemotherapy,” said Jia Ruan, MD, PhD, Associate Professor of Clinical Medicine at
in New York, and lead author of this study, in a statement. “With this front-line treatment, we were able to achieve a very high quality and durable response rate without needing to use chemotherapy. It’s very meaningful for the patients who have always been told that their disease is without a cure.”
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Lenalidomide Plus Rituximab AppearsPromising as First-Line Therapy for Mantle Cell Lymphoma来那度胺联合利妥昔单抗作为治疗mantle细胞淋巴瘤的一线似乎很有希望Mantle cell lymphoma, which is characterized byCD5-positive, CD23-negative follicular mantle B cells with t(11:14)(q13;q32)translocation and cyclin D1 overexpression, is generally incurable andassociated with a median survival of between 4 and 5 years. Although front-linetreatment for mantle cell lymphoma is not standardized, it usually includescytotoxic chemotherapy, which can be clinically challenging for patients, who areusually older and mayfind the side effects from high-dose chemotherapy and hematopoieticcell transplantation difficult to manage.mantle细胞淋巴瘤，其特征是CD5阳性，CD23阴性滤泡mantle B细胞伴有t(11:14) q ( 13;q32)转位和细胞周期蛋白D1过度表达，一般是无法治愈的，中位生存期为4-5年。虽然mantle细胞淋巴瘤没有标准的一线治疗方法，它通常包括细胞毒性化疗，这对于年龄较高的病人，高剂量化疗可能会发现副作用以及难以进行造血细胞移植的病人在临床上可能具有挑战性。To determine whether the initial management ofmantle cell lymphoma using biologic agents might offer effective diseasecontrol and fewer side effects than chemotherapy approaches, a phase II studyby Ruan et al was launched to evaluate the efficacy and safety of thecombination of lenalidomide (Revlimid) and rituximab (Rituxan) as induction andmaintenance therapy in patients with previously untreated mantle cell lymphoma.The study was published in .为确定用生物制剂初始治疗mantle细胞淋巴瘤比化疗方法是否可有效地控制疾病和减少化疗副作用，Ruan等人启动了一个II期研究以评价来那度胺（Revlimid）联合利妥昔单抗（Rituxan）作为诱导和维持治疗对以前没有治疗过的mantle细胞淋巴瘤患者的疗效和安全性。这项研究发表于新英格兰医学杂志上。Study MethodologyThe researchersconducted a single-group, multicenter phase II trial with induction andmaintenance phases. A total of 38 patients with untreated mantle cell lymphomawere enrolled in the study from July 2011 through April 2014. The median agewas 65, all patients had stage III or IV disease, and the proportions ofparticipants with low-risk, intermediate-risk, and high-risk disease atbaseline were similar: 34%, 34%, and 32%, respectively.研究方法研究人员进行了单组，包含诱导和维持期的多中心II期试验。在这个2011年4月至2014年7月的试验中，共入选38名未经治疗的mantle细胞淋巴瘤患者。中位年龄为65岁，所有患者均为Ⅲ或Ⅳ期疾病，在基线时，参与者低风险，中风险和高风险疾病的比例是相似的，分别为：34%，34%，和32%。During the induction phase, lenalidomide wasadministered at a dose of 20 mg daily on days 1 through 21 of every 28-daycycle for 12 the dose was escalated to 25 mg daily after the firstcycle if no dose-limiting adverse events occurred during the first cycle andwas reduced to 15 mg daily during the maintenance phase. Rituximab wasadministered once weekly for the first 4 weeks and then once every other cycleuntil disease progression.在诱导期，来那度胺给药剂量为每日20毫克，第1至第21天给药，每28天为1周期，共为12个周期；如果在第一周期内无剂量限制性不良事件发生，剂量升到每日25毫克，在维持期，剂量减少到每天15毫克。利妥昔单抗前4周每周一次给药，然后每隔一周给药，直到疾病进展。The primary endpoint was overall response rate.Secondary endpoints included outcomes related to safety, survival, and qualityof life.主要终点为总反应率。次要终点包括与安全、生存期和生活质量相关的结局。Study Findings研究结果At a median follow-up of 30 months (throughFebruary 2015), the overall response rate among evaluable participants was 92%(95% confidence interval [CI] = 78%–98%), and the complete response rate was64% (95% CI = 46%–79%); medianprogression-free survival had not been reached. The 2-year progression-free survival was estimated to be85% (95% CI = 67%–94%), and the 2-year overall survival 97% (95% CI = 79%–99%).A response to treatment was associated with improvement in quality of life.中位随访期为30个月（到2015年2月），在可评价的参与者中，整体反应率为92%（95%可信区间[CI] = 78%，–98%），完全缓解率为64%（95%可信区间为46%–79%）；中位无进展生存期尚未达到。2年无进展生存期估计为85%（95%可信区间为67% - 94%），2年总生存率为97%（95%可信区间为79% - 99%）。对治疗有反应者生活质量改善。The most common grade 3 or 4 adverse eventswere neutropenia (50%), rash (29%), thrombocytopenia (13%), an inflammatorysyndrome, or “tumor flare” (11%), anemia (11%), serum sickness (8%), andfatigue (8%).最常见的3级或4级不良反应为中性粒细胞减少症（50%）、皮疹（29%）、血小板减少症（13%）、炎症综合征，或“肿瘤复发”（11%）、贫血（11%）、血清病（8%）和疲劳（8%）。Preserving Quality of Life保持生活质量“For patients, their quality of life waspreserved or improved, and that’s a huge step up from regular chemotherapy,”said Jia Ruan, MD, PhD, Associate Professor of Clinical Medicine at
in NewYork, and lead author of this study, in a statement. “With this front-linetreatment, we were able to achieve a very high quality and durable responserate without needing to use chemotherapy. It’s very meaningful for the patientswho have always been told that their disease is without a cure.” “患者的生活质量得以保存或改善，这是从常规化疗向前迈出的巨大一步，”在一份声明中，纽约威尔康奈尔医学院副教授，这项研究的领导者Jia Ruan博士说，“有了这一线治疗，我们能够获得非常高质量的和持久的反应率，而不需要使用化疗。对于那些已被告知他们的疾病无法医治的病人来说，这是非常有意义的。”
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英文字符数：3452；汉文字符数：1114来那度胺联合利妥昔单抗作为治疗mantle细胞淋巴瘤的一线似乎很有希望mantle细胞淋巴瘤，其特征是CD5阳性，CD23阴性滤泡mantle B细胞伴有t(11:14) q ( 13;q32)转位和细胞周期蛋白D1过度表达，一般是无法治愈的，中位生存期为4-5年。虽然mantle细胞淋巴瘤没有标准的一线治疗方法，它通常包括细胞毒性化疗，这对于年龄较高的病人，高剂量化疗可能会发现副作用以及难以进行造血细胞移植的病人在临床上可能具有挑战性。为确定用生物制剂初始治疗mantle细胞淋巴瘤比化疗方法是否可有效地控制疾病和减少化疗副作用，Ruan等人启动了一个II期研究以评价来那度胺（Revlimid）联合利妥昔单抗（Rituxan）作为诱导和维持治疗对以前没有治疗过的mantle细胞淋巴瘤患者的疗效和安全性。这项研究发表于新英格兰医学杂志上。研究方法研究人员进行了单组，包含诱导和维持期的多中心II期试验。在这个2011年4月至2014年7月的试验中，共入选38名未经治疗的mantle细胞淋巴瘤患者。中位年龄为65岁，所有患者均为Ⅲ或Ⅳ期疾病，在基线时，参与者低风险，中风险和高风险疾病的比例是相似的，分别为：34%，34%，和32%。在诱导期，来那度胺给药剂量为每日20毫克，第1至第21天给药，每28天为1周期，共为12个周期；如果在第一周期内无剂量限制性不良事件发生，剂量升到每日25毫克，在维持期，剂量减少到每天15毫克。利妥昔单抗前4周每周一次给药，然后每隔一周给药，直到疾病进展。主要终点为总反应率。次要终点包括与安全、生存期和生活质量相关的结局。研究结果中位随访期为30个月（到2015年2月），在可评价的参与者中，整体反应率为92%（95%可信区间[CI] = 78%，–98%），完全缓解率为64%（95%可信区间为46%–79%）；中位无进展生存期尚未达到。2年无进展生存期估计为85%（95%可信区间为67% - 94%），2年总生存率为97%（95%可信区间为79% - 99%）。对治疗有反应者生活质量改善。最常见的3级或4级不良反应为中性粒细胞减少症（50%）、皮疹（29%）、血小板减少症（13%）、炎症综合征，或“肿瘤复发”（11%）、贫血（11%）、血清病（8%）和疲劳（8%）。保持生活质量“患者的生活质量得以保存或改善，这是从常规化疗向前迈出的巨大一步，” 在一份声明中，纽约威尔康奈尔医学院副教授，这项研究的领导者Jia Ruan博士说，“有了这一线治疗，我们能够获得非常高质量的和持久的反应率，而不需要使用化疗。对于那些已被告知他们的疾病无法医治的病人来说，这是非常有意义的。”
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【medical-news】【资讯翻译】持续性雷那度胺/低剂量地塞米松治疗：新诊黑色素瘤老年患者的新选择？
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认领翻译的战友请跟帖注明“本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领&请根据自己专业背景选择认领，如使用翻译软件翻译，被发现者扣分1-2分新近参与本次活动的会员请查看：寻找最近的翻译贴请查看：91&bid=116&t=1&c=1&age=7&bid=116&limit=30&o=1翻译时请参照版规 Continuous Lenalidomide/Low-Dose Dexamethasone: A New Option for Older Patients With Newly Diagnosed Myeloma First-line treatment of newly diagnosed multiple myeloma using the Rd regimen (continuous lenalidomide [Revlimid] plus low-dose dexamethasone) was superior to standard triplet treatment with MPT (melphalan, prednisone, and thalidomide [Thalomid]) for 72 weeks, according to initial results of the FIRST (Front-Line Investigation of Revlimid/Dexamethasone vs Standard Thalidomide) trial presented at the 55th Annual Meeting of the American Society of Hematology (ASH) in New Orleans.Multiple BenefitsPatients treated with Rd were 28% less likely to experience disease progression or death compared with those who received MPT, and Rd improved overall survival, response rates, and duration of response. Additionally, Rd appears to have a safety advantage over MPT by causing fewer secondary hematologic malignancies.“Traditionally, newly diagnosed multiple myeloma patients have received short bursts of treatment, while continuous treatment was reserved for relapsed patients. However, we believe that these new results will help encourage more research on the efficacy and safety of continuous treatment for newly diagnosed patients to help maximize their chances for overall long-term survival,” stated lead author Thierry Facon, MD, Services des Maladies du Sang, H?pital Claude Huriez, and CHRU Lille, France.“Continuous Rd represents a new standard of care for older transplant-ineligible patients. For some patients with low-risk multiple myeloma, this continuous regimen could make this disease a manageable, chronic condition,” Dr. Facon stated.Study DetailsThe multicenter, open-label, phase III trial, conducted at 246 centers in 18 countries, enrolled 1,623 newly diagnosed multiple myeloma patients who were ineligible for stem cell transplant due to older age or other reasons. Median age was 73 (range, 40–92 years), and 35% of patients were aged 75 41% had stage III disease.Participants were randomly assigned to one of three arms: continuous Rd in 28-day cycles until disease progression. Rd for 18 cycles (72 weeks), or MPT for 12 cycles (72 weeks). Responses were assessed after each cycle of chemotherapy. Dose adjustments were permitted for adverse events. All patients received antithrombotic prophylaxis as part of the protocol.At a median follow-up of 37 months, the study met its primary endpoint of progression-free survival comparing continuous Rd vs MPT for 72 weeks, demonstrating a highly significant 28% reduction in risk of disease progression or death (P = .00006). Median progression-free survival was 25.5 months for continuous Rd vs 21.2 months for MPT.Median progression-free survival was also significantly better for continuous Rd vs Rd for 18 cycles: 25.5 months vs 20.7 months (P = .00001).Even more important, continuous Rd led to improvement in overall survival (59% at 4 years) vs MPT (51.4% at 4 years). The 4-year median survival rate in patients receiving Rd for 18 cycles was 55.7%.Continuous Rd achieved consistent improvement over MPT for all secondary endpoints: Overall response rate (partial response or better) was 75% vs 62% (P & .0001), respectively.Adverse EventsThe safety profiles for the two treatment arms (continuous Rd vs MPT) were similar, with numerically fewer hematologic side effects in the doublet arm, as well as fewer hematologic malignancies. In this study, the incidence of secondary solid cancers was identical in both arms (2%), and the incidence of secondary hematologic malignancies was 0.4% with continuous Rd vs 2.2% with MPT.Relevant grade 3 or 4 adverse events in the continuous Rd arm vs MPT, respectively, were neutropenia (28% vs 45%), thrombocytopenia (8% vs 11%), febrile neutropenia (1% vs 3%), infection (29% vs 17%), neuropathy (5% vs 15%), and deep-vein thrombosis (5% vs 3%). ■Disclosure: The study was supported by Celgene and the French Francophone Myeloma Intergroup. Dr. Facon is a member of the Board of Directors or advisory committee and the speakers bureau for Celgene.
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@shumufeng，楼主您好，标题好像错了，应该是骨髓瘤，而不是黑色素瘤。
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Continuous Lenalidomide/Low-Dose Dexamethasone: A New Option for Older Patients With Newly Diagnosed Myeloma持续来那度胺/低剂量地塞米松治疗：新诊断骨髓瘤老年患者的新选择First-line treatment of newly diagnosed multiple myeloma using the Rd regimen (continuous lenalidomide [Revlimid] plus low-dose dexamethasone) was superior to standard triplet treatment with MPT (melphalan, prednisone, and thalidomide [Thalomid]) for 72 weeks, according to initial results of the FIRST (Front-Line Investigation of Revlimid/Dexamethasone vs Standard Thalidomide) trial presented at the 55th Annual Meeting of the American Society of Hematology (ASH) in New Orleans.通过使用一线来那度胺方案（持续来那度胺[瑞复美]加低剂量地塞米松）治疗新诊断的多发性骨髓瘤优于使用MPT（马法兰，强的松和沙利度胺[thalomid]）的标准三联治疗方案治疗多发性骨髓瘤72周，基于FIRST（来那度胺/地塞米松对比标准沙利度胺的一线研究）临床试验的初期结果，这一结果发表在第55届美国血液学学会年会上。Multiple Benefits多重效益Patients treated with Rd were 28% less likely to experience disease progression or death compared with those who received MPT, and Rd improved overall survival, response rates, and duration of response. Additionally, Rd appears to have a safety advantage over MPT by causing fewer secondary hematologic malignancies.使用来那度胺方案治疗的患者对比使用MPT方案治疗的患者经历疾病进展或死亡低28％。来那度胺方案改善整体存活率、响应率和持续响应时间。此外，来那度胺方案对比MTP方案表现出安全性优势具有更少的二次恶心血液病发生。“Traditionally, newly diagnosed multiple myeloma patients have received short bursts of treatment, while continuous treatment was reserved for relapsed patients. However, we believe that these new results will help encourage more research on the efficacy and safety of continuous treatment for newly diagnosed patients to help maximize their chances for overall long-term survival,” stated lead author Thierry Facon, MD, Services des Maladies du Sang, H?pital Claude Huriez, and CHRU Lille, France.“传统上新诊断的多发性骨髓瘤患者会接受短时间的治疗，持续治疗只会保留给复发的患者。可是我们相信这些新的研究结果将有助于鼓励更多的针对持续性治疗新诊断多发性骨髓瘤患者的研究，这些更多的研究将会最大限度的提高他们整体长期生存的机会，”第一作者法国里尔大学血液病服务克劳福德医院Thierry Facon博士说。“Continuous Rd represents a new standard of care for older transplant-ineligible patients. For some patients with low-risk multiple myeloma, this continuous regimen could make this disease a manageable, chronic condition,” Dr. Facon stated.“持续来那度胺方案代表不适合移植老年患者治疗的新标准。对于部分患者低风险的多发性骨髓瘤，这一持续治疗方案可使此疾病处于可控制的慢性状态，”Facon博士表示。Study Details试验细节The multicenter, open-label, phase III trial, conducted at 246 centers in 18 countries, enrolled 1,623 newly diagnosed multiple myeloma patients who were ineligible for stem cell transplant due to older age or other reasons. Median age was 73 (range, 40–92 years), and 35% of patients were aged 75 41% had stage III disease.这是一多中心、开放标签的Ⅲ期临床试验，这一临床试验在18个国家的246个中心开展，共招募了1623个新诊断多发性骨髓瘤患者，这些患者由于年龄大或其他原因而不适合进行干细胞移植。患者的中位年龄为73岁（年龄范围，40-92岁），35％的患者年龄≥75岁，41％的患者病情处于第Ⅲ阶段。Participants were randomly assigned to one of three arms: continuous Rd in 28-day cycles until disease progression. Rd for 18 cycles (72 weeks), or MPT for 12 cycles (72 weeks). Responses were assessed after each cycle of chemotherapy. Dose adjustments were permitted for adverse events. All patients received antithrombotic prophylaxis as part of the protocol.受试者被随机分配到三种治疗方案中的一种，这三种治疗方案为：28天的周期内持续来那度胺方案治疗直到疾病进展；来那度胺方案18个周期共72周治疗；MPT方案12个周期共72周治疗。每个化疗周期后评估响应。由于不良反应可允许调整剂量。作为协议的一部分所有患者要接收抗血栓预防。At a median follow-up of 37 months, the study met its primary endpoint of progression-free survival comparing continuous Rd vs MPT for 72 weeks, demonstrating a highly significant 28% reduction in risk of disease progression or death (P = .00006). Median progression-free survival was 25.5 months for continuous Rd vs 21.2 months for MPT.中位随访时间为37个月，在该研究中持续来那度胺方案对比MPT方案治疗72周已达到无进展生存期的主要终点，结果显示疾病进展或死亡风险统计学降低28％（p=0.00006）。中位无进展生存期持续来那度胺方案和MPT方案分别为25.5个月和21.2个月。Median progression-free survival was also significantly better for continuous Rd vs Rd for 18 cycles: 25.5 months vs 20.7 months (P = .00001).持续来那度胺方案和来那度胺18周期方案中位无进展生存期也具有统计学意义，两组数据分别为25.5个月和20.7个月（p=0.00001）。Even more important, continuous Rd led to improvement in overall survival (59% at 4 years) vs MPT (51.4% at 4 years). The 4-year median survival rate in patients receiving Rd for 18 cycles was 55.7%.甚至更重要的是，持续来那度胺方案对比MPT方案导致更显著的总生存期，两组数据分别为4年59％和4年51.4％。来那度胺18周期治疗方案患者的4年中位生存率为55.7％。Continuous Rd achieved consistent improvement over MPT for all secondary endpoints: Overall response rate (partial response or better) was 75% vs 62% (P & .0001), respectively.持续来那度胺方案对比MPT方案获得次要终点的连续改善：总生存率（部分响应或者更好）分别为75％和62％（p＜0.0001）。Adverse Events不良反应The safety profiles for the two treatment arms (continuous Rd vs MPT) were similar, with numerically fewer hematologic side effects in the doublet arm, as well as fewer hematologic malignancies. In this study, the incidence of secondary solid cancers was identical in both arms (2%), and the incidence of secondary hematologic malignancies was 0.4% with continuous Rd vs 2.2% with MPT.两治疗组（持续来那度胺和MPT方案）的安全性事件是相似的，两治疗组具有数量较少的血液学副作用，以及较少的血液系统恶心肿瘤。在此项研究中，二次实体瘤的发生率在两个治疗组是相同的（2％），二次恶性血液病的发生率持续来那度胺组合MPT方案治疗组分别为0.4％和2.2％。Relevant grade 3 or 4 adverse events in the continuous Rd arm vs MPT, respectively, were neutropenia (28% vs 45%), thrombocytopenia (8% vs 11%), febrile neutropenia (1% vs 3%), infection (29% vs 17%), neuropathy (5% vs 15%), and deep-vein thrombosis (5% vs 3%). ■在持续来那度胺组合MPT方案组相关3级或者4级不良反应分别为中性粒细胞减少症（28% vs 45%），血小板减少（8% vs 11%），发热性中性粒细胞减少（1% vs 3%），感染（29% vs 17%），神经病变（5% vs 15%），和深静脉血栓形成（5% vs 3%）。Disclosure: The study was supported by Celgene and the French Francophone Myeloma Intergroup. Dr. Facon is a member of the Board of Directors or advisory committee and the speakers bureau for Celgene.披露：这项研究是由Celgene公司和法国法语骨髓瘤研究机构共同支持。Facon博士是Celgene公司董事会的一员，也是顾问委员会和讲师团成员。
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持续来那度胺/低剂量地塞米松治疗：新诊断骨髓瘤老年患者的新选择通过使用一线来那度胺方案（持续来那度胺[瑞复美]加低剂量地塞米松）治疗新诊断的多发性骨髓瘤优于使用MPT（马法兰，强的松和沙利度胺[thalomid]）的标准三联治疗方案治疗多发性骨髓瘤72周，基于FIRST（来那度胺/地塞米松对比标准沙利度胺的一线研究）临床试验的初期结果，这一结果发表在第55届美国血液学学会年会上。多重效益使用来那度胺方案治疗的患者对比使用MPT方案治疗的患者经历疾病进展或死亡低28％。来那度胺方案改善整体存活率、响应率和持续响应时间。此外，来那度胺方案对比MTP方案表现出安全性优势具有更少的二次恶心血液病发生。 “传统上新诊断的多发性骨髓瘤患者会接受短时间的治疗，持续治疗只会保留给复发的患者。可是我们相信这些新的研究结果将有助于鼓励更多的针对持续性治疗新诊断多发性骨髓瘤患者的研究，这些更多的研究将会最大限度的提高他们整体长期生存的机会，”第一作者法国里尔大学血液病服务克劳福德医院Thierry Facon博士说。 “持续来那度胺方案代表不适合移植老年患者治疗的新标准。对于部分患者低风险的多发性骨髓瘤，这一持续治疗方案可使此疾病处于可控制的慢性状态，”Facon博士表示。试验细节这是一多中心、开放标签的Ⅲ期临床试验，这一临床试验在18个国家的246个中心开展，共招募了1623个新诊断多发性骨髓瘤患者，这些患者由于年龄大或其他原因而不适合进行干细胞移植。患者的中位年龄为73岁（年龄范围，40-92岁），35％的患者年龄≥75岁，41％的患者病情处于第Ⅲ阶段。受试者被随机分配到三种治疗方案中的一种，这三种治疗方案为：28天的周期内持续来那度胺方案治疗直到疾病进展；来那度胺方案18个周期共72周治疗；MPT方案12个周期共72周治疗。每个化疗周期后评估响应。由于不良反应可允许调整剂量。作为协议的一部分所有患者要接收抗血栓预防。中位随访时间为37个月，在该研究中持续来那度胺方案对比MPT方案治疗72周已达到无进展生存期的主要终点，结果显示疾病进展或死亡风险统计学降低28％（p=0.00006）。中位无进展生存期持续来那度胺方案和MPT方案分别为25.5个月和21.2个月。持续来那度胺方案和来那度胺18周期方案中位无进展生存期也具有统计学意义，两组数据分别为25.5个月和20.7个月（p=0.00001）。甚至更重要的是，持续来那度胺方案对比MPT方案导致更显著的总生存期，两组数据分别为4年59％和4年51.4％。来那度胺18周期治疗方案患者的4年中位生存率为55.7％。持续来那度胺方案对比MPT方案获得次要终点的连续改善：总生存率（部分响应或者更好）分别为75％和62％（p＜0.0001）。不良反应两治疗组（持续来那度胺和MPT方案）的安全性事件是相似的，两治疗组具有数量较少的血液学副作用，以及较少的血液系统恶心肿瘤。在此项研究中，二次实体瘤的发生率在两个治疗组是相同的（2％），二次恶性血液病的发生率持续来那度胺组合MPT方案治疗组分别为0.4％和2.2％。在持续来那度胺组合MPT方案组相关3级或者4级不良反应分别为中性粒细胞减少症（28% vs 45%），血小板减少（8% vs 11%），发热性中性粒细胞减少（1% vs 3%），感染（29% vs 17%），神经病变（5% vs 15%），和深静脉血栓形成（5% vs 3%）。披露：这项研究是由Celgene公司和法国法语骨髓瘤研究机构共同支持。Facon博士是Celgene公司董事会的一员，也是顾问委员会和讲师团成员。编译：1240
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