Bước đầu đánh giá hiệu quả điều trị của phác đồ có Daratumumab trên 13 bệnh nhân đa u tủy tái phát kháng trị tại Bệnh viện Chợ Rẫy

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Tác giả: Dương Bích Trâm Huỳnh, Hồng Hoa Huỳnh, Khắc Tùng Nguyễn, Thị bé Út Nguyễn, Thị Thanh Trúc Nguyễn, Nam Phan, Monivong Cheanh Beaupha Suzanne, Phạm Hồng Diễm Trương, Thế Hà Vy

Ngôn ngữ: vie

Ký hiệu phân loại: 616 Diseases

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 380-386

Bộ sưu tập: Metadata

ID: 500808

Thêm vào giỏ

Bước đầu đánh giá hiệu quả điều trị bệnh nhân đa u tuỷ tái phát kháng trị với phác đồ có Daratumumab tại bệnh viện Chợ Rẫy từ ngày 01 tháng 01 năm 2019 đến 31 tháng 07 năm 2022 Đối tượng và phương pháp nghiên cứu: Đối tượng nghiên cứu: Tất cả các bệnh nhân được chẩn đoán Đa u tuỷ tái phát kháng trị được điều trị với phác đồ có Daratumumab tại khoa Huyết Học bệnh viện Chợ Rẫy từ ngày 01 tháng 01 năm 2019 đến 31 tháng 07 năm 2022 Phương pháp nghiên cứu: Mô tả hàng loạt ca Kết quả Trong thời gian từ ngày 1/1/2019 đến ngày 31/7/2022, tại khoa Huyết Học Lâm Sàng và Đơn vị điều trị trong ngày bệnh viện Chợ Rẫy, chúng tôi ghi nhận tổng cộng 13 bệnh nhân đa u tuỷ tái phát kháng trị được điều trị với phác đồ Daratumumab tham gia vào nghiên cứu. Tại thời điểm đánh giá sau 2 chu kì điều trị, hầu hết bệnh nhân đạt đáp ứng bệnh với 5/13 (38.5%) đạt VGPR và 6/13 (46.2%) đạt PR. Tại thời điểm kết thúc nghiên cứu, có 10 bệnh nhân hoàn tất 4 chu kì hoá trị. Đánh giá tại thời điểm kết thúc 4 chu kì, ghi nhận tỉ lệ đáp ứng bệnh cao, chiếm 70% với 3/10 (30%) đạt VGPR và 4/10 (40%) đạt PR. Theo dõi 13 bệnh nhân, chúng tôi ghi nhận biến chứng huyết học là biến chứng thường gặp nhất, 5/13 bệnh nhân xuất hiện biến chứng huyết học, hầu hết ghi nhận biến chứng độ II/III, cần phải truyền máu hỗ trợ. Biến chứng thường gặp thứ hai là độc tính thần kinh ngoại biên, độc tính này thường ghi nhận độ I/II và không cần phải ngưng liệu trình hoá trị. Kết luận: Đa u tuỷ là bệnh lý ác tính không thể chữa khỏi với hầu hết bệnh nhân tái phát. Việc thêm Daratumumab vào phác đồ điều trị mang lại hiệu quả cao với tỷ lệ đáp ứng bệnh toàn bộ hơn 80%. Bên cạnh đó, tính an toàn cao khi sử dụng phác đồ có Daratumumab với hầu hết tác dụng phụ có thể kiểm soát được trên lâm sàng. Tuy nhiên, cần số lượng mẫu lớn hơn để củng cố thêm tính hiệu quả và an toàn của phác đồ này trên đối tượng đa u tuỷ tái phát kháng trị.Initial evaluation of Daratumumab regiment in treatment of 13 RRMM patients in Cho Ray Hospital from 1st January 2019 to 31st July 2022 Subjects and Methods: Subjects: All RRMM patients received therapy with Daratumumab at Hematology Deparment at Cho Ray Hospital from 1st January 2019 to 31st July 2022 Methods: Descriptive and observational study Results: From 1st January 2019 to 31st July 2022, at Cho Ray hospital, we had 13 RRMM patients who treated with Daratumumab regimens enrolled in the study. After 2 cycles of chemotherapy, most patients achieved disease response, in which 5/13 (38.5%) patients achieved VGPR and 6/13 (46.2%) achieved PR. At the end of the study, 10 patients completed 4 cycles of chemotherapy. After 4 cycles of chemotherapy, the response rate is approximately 70%, in which 3/10 (30%) patients achieved VGPR and 4/10 (40%) achieved PR. Following 13 patients, hematologic adverse event is the most common, 5/13 patients appeared hematological adverse event of grade II/III and required supportive blood transfusion. The second common adverse event is peripheral neurotoxicity, which is usually grade I/II and does not require discontinuation of chemotherapy. Conclusion: Multiple myeloma is an incurable malignancy and almost all patients eventually relapse. Adding Daratumumab to the treatment regimen is highly effective because the response rate is more than 80%. Besides, the patients' safety is ensured when using Daratumumabbased regimen because most side effects can be controlled clinically. However, a larger sample size is needed to further reinforce the efficacy and safety of this regimen in patients with relapsed and refractory multiple myeloma.

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