RESUMEN
PURPOSE: This randomized phase III study compared bendamustine and prednisone (BP) to standard melphalan and prednisone (MP) treatment in previously untreated patients with multiple Myeloma (MM). PATIENTS AND METHODS: To be included, patients had to have histologically and cytologically proven stage II with progressive diseases or stage III MM. They were randomly assigned to receive BP (n=68) or MP (n=63). The primary endpoint was the time to treatment failure (TTF). Secondary endpoints included survival, remission rate, toxicity and quality of life. RESULTS: The overall response rate was 75% in the BP and 70% in the MP group. A significantly higher number of patients treated with BP achieved a complete remission than did patients receiving MP (32 vs. 13%; P=0.007), and the maximum response was achieved more rapidly in patients treated with BP compared to those receiving MP (6.8 vs. 8.7 cycles; P<0.02). TTF and remission duration were significantly longer in the BP group. Patients receiving BP had higher QoL scores and reported pain less frequently than patients receiving MP. CONCLUSION: BP is superior to MP with respect to complete remission rate, TTF, cycles needed to achieve maximum remission and quality of life and should be considered the new standard in first-line treatment of MM patients not eligible for transplantation.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Melfalán/administración & dosificación , Mieloma Múltiple/tratamiento farmacológico , Compuestos de Mostaza Nitrogenada/administración & dosificación , Prednisona/administración & dosificación , Calidad de Vida , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Clorhidrato de Bendamustina , Supervivencia sin Enfermedad , Femenino , Alemania Oriental , Humanos , Masculino , Melfalán/efectos adversos , Persona de Mediana Edad , Mieloma Múltiple/mortalidad , Mieloma Múltiple/patología , Compuestos de Mostaza Nitrogenada/efectos adversos , Prednisona/efectos adversos , Inducción de Remisión , Análisis de Supervivencia , Factores de Tiempo , Insuficiencia del TratamientoRESUMEN
An 28 years old women came on his 7. post partum day with an lower abdominal pain on the right hand side with the diagnosis of an unilateral rotating ovarian tumor. After computed tomography, ultrasound and laparoscopy the adnectomia dextra by laparotomy was performed. In the histology we find an ovarian vein thrombosis. The following therapy was made with an therapeutic anticoagulation with heparin combined with an antibiotic therapy and later with an oral anticoagulation.
Asunto(s)
Ovario/irrigación sanguínea , Trastornos Puerperales/cirugía , Trombosis/cirugía , Adulto , Diagnóstico Diferencial , Diagnóstico por Imagen , Femenino , Humanos , Trastornos Puerperales/patología , Trombosis/patología , Venas/patología , Venas/cirugíaRESUMEN
On the one hand, the results of the study show a relatively large number (44%) of bronchopulmonary secondary diseases in a non-selected number of patients with condition after myocardial infarction, on the other hand, partly considerable respiratory functional reductions with clear decrease in vitality and delayed and restricted professional rehabilitation are to be proved. Of particular significance was the arterial hypoxaemia as an important functional determinant in the pathophysiology of the chronic coronary heart disease. From this results the necessity of a complex cardiopulmonary diagnostics in the dispensary care of patients with condition of myocardial infarction, a differentiated medication. In particular becomes evident the balanced application of beta-receptor blockers and glycosides.