Clinical efficacy of methylprednisolone combined with immunosuppressants and CAPP chemotherapy in the treatment of thymoma with Myasthenia Gravis

Objective: To evaluate the clinical efficacy of cyclophosphamide, doxorubicin, cisplatin plus prednisone (CAPP), and methylprednisolone (mPSL) plus immunosuppressants in the treatment of thymoma patients with myasthenia gravis (TMG), which provides new treatment ideas for clinicians. Methods: 1. The clinical data of TMG who were treated with CAPP or high-dose mPSL from 2018 to 2023 were collected and divided into CAPP group and mPSL group. 2. The myasthenia gravis muscular endurance score (MGMES) is used to quantify the severity of the disease. The MGMES and the therapeutic effect of thymoma were compared between the two groups, and the side effects were recorded. Results: 1. The response rate (PR or CR) for the TMG of the CAPP group and the mPSL group was respectively 41.4% and 89.2%. The difference was statistically significant (P<0.05). 2. In the CAPP group, the MGMES of the TMG decreased by an average of 10.55±13.86. In the mPSL group, the MGMES decreased by an average of 24.83±22.26. The difference was statistically significant ( P <0.05). 3. The incidence of toxic and side effects was 48.28% in the CAPP group and 45.95% in the mPSL group. During the course of treatment, Myasthenia crisis occurred in 3 cases in the mPSL group. Conclusions: 1. The mPSL combined with immunosuppressants is more effective in the TMG. 2. There is no difference in the incidence of side effects between the two groups, but there was a possibility of myasthenia gravis crisis in the mPSL group.