内容紹介
Masahiro Yasuda,Tomoya Tachi,Michi Umeda,Katsuhiro Nagaya,Tomohiro Osawa,Atsushi Ichihashi,Hideko Goto,Senji Kasahara,Takeshi Takahashi,Chitoshi Goto,Hitomi Teramachi
Summary
The onset of thrombocytopenia and related factors was analyzed in patients with multiple myeloma(MM)who were receiving lenalidomide(Len)therapy at the Department of Hematology, Gifu Municipal Hospital between July 2010 and March 2014. We included 28 MM patients(18 males and 10 females)with a median age of 70.5(range: 55-84)years. The patients were examined from the start of Len therapy until treatment discontinuation, prolongation, or dose reduction.
A significant correlation was observed between platelet(Plt)count prior to the start of Len therapy(pre-treatment Plt)and the difference between pre-treatment Plt and the minimum Plt up to the point in time of treatment discontinuation, prolongation, or dosage reduction(min-Plt)(r=0.674, p<0.001). Univariate analysis revealed that factors causing thrombocytopenia of grade 2 or above as a side-effect showed a significant difference when the Plt count was below the lower limit of the normal value(<14.0×104/μL)(p=0.011). Factors with p<0.25 in the univariate analysis and daily dosage of Len were examined by multivariate analysis; thus, a Plt count below the lower limit of the normal value was identified as a factor(odds ratio: 15.12, 95% confidence interval[CI]: 1.712-133.5, p=0.015). In conclusion, we suggest that a Plt count below the lower limit of the normal value prior to the start of Len therapy is a prognostic factor for thrombocytopenia as a side-effect of Len therapy.
要旨
2010年7月～2014年3月に岐阜市民病院血液内科において,レナリドミド(Len)が投与された多発性骨髄腫(MM)患者の血小板減少症発現とその因子について解析を行った。対象はMM患者28症例で,年齢の中央値(範囲)は70.5(55～84)歳,男性18名,女性10名であった。Len投与開始から投与中止・延期または投与量が減量となった時点までを調査した。「Len投与開始前の血小板数(Plt)(服用前Plt)」と(「服用前Plt」―「投与中止・延期または投与量が減量となった時点までのPltの最低値(Min-Plt)」)の相関に関しては,有意な相関を認めた(r=0.674,p<0.001)。単変量解析においてgrade 2以上のPlt減少の副作用を引き起こす因子は,「Pltの基準値下限(14.0×104/μL)未満」で有意な差を認めた(p=0.011)。単変量解析においてp<0.25であった因子およびLenの1日投与量に関して多変量解析を行った結果,「Pltの基準値下限未満」の因子が検出された[odds ratio: 15.12,95% confidence interval(CI): 1.712-133.5,p=0.015]。結論として,Len投与に伴う副作用である血小板減少症の予測因子はLen投与開始前の「Pltの基準値下限未満」であることが示唆された。
目次
Summary
The onset of thrombocytopenia and related factors was analyzed in patients with multiple myeloma(MM)who were receiving lenalidomide(Len)therapy at the Department of Hematology, Gifu Municipal Hospital between July 2010 and March 2014. We included 28 MM patients(18 males and 10 females)with a median age of 70.5(range: 55-84)years. The patients were examined from the start of Len therapy until treatment discontinuation, prolongation, or dose reduction.
A significant correlation was observed between platelet(Plt)count prior to the start of Len therapy(pre-treatment Plt)and the difference between pre-treatment Plt and the minimum Plt up to the point in time of treatment discontinuation, prolongation, or dosage reduction(min-Plt)(r=0.674, p<0.001). Univariate analysis revealed that factors causing thrombocytopenia of grade 2 or above as a side-effect showed a significant difference when the Plt count was below the lower limit of the normal value(<14.0×104/μL)(p=0.011). Factors with p<0.25 in the univariate analysis and daily dosage of Len were examined by multivariate analysis; thus, a Plt count below the lower limit of the normal value was identified as a factor(odds ratio: 15.12, 95% confidence interval[CI]: 1.712-133.5, p=0.015). In conclusion, we suggest that a Plt count below the lower limit of the normal value prior to the start of Len therapy is a prognostic factor for thrombocytopenia as a side-effect of Len therapy.
要旨
2010年7月～2014年3月に岐阜市民病院血液内科において,レナリドミド(Len)が投与された多発性骨髄腫(MM)患者の血小板減少症発現とその因子について解析を行った。対象はMM患者28症例で,年齢の中央値(範囲)は70.5(55～84)歳,男性18名,女性10名であった。Len投与開始から投与中止・延期または投与量が減量となった時点までを調査した。「Len投与開始前の血小板数(Plt)(服用前Plt)」と(「服用前Plt」―「投与中止・延期または投与量が減量となった時点までのPltの最低値(Min-Plt)」)の相関に関しては,有意な相関を認めた(r=0.674,p<0.001)。単変量解析においてgrade 2以上のPlt減少の副作用を引き起こす因子は,「Pltの基準値下限(14.0×104/μL)未満」で有意な差を認めた(p=0.011)。単変量解析においてp<0.25であった因子およびLenの1日投与量に関して多変量解析を行った結果,「Pltの基準値下限未満」の因子が検出された[odds ratio: 15.12,95% confidence interval(CI): 1.712-133.5,p=0.015]。結論として,Len投与に伴う副作用である血小板減少症の予測因子はLen投与開始前の「Pltの基準値下限未満」であることが示唆された。