三氧化二砷联合沙利度胺、地塞米松治疗老年难治复发性多发性骨髓瘤的效果

Effects of arsenic trioxide, thalidomide and dexamethasone on elderly patients with refractory and relapsed multiple myeloma

目的探讨三氧化二砷联合沙利度胺、地塞米松治疗难治复发性老年多发性骨髓瘤患者的临床效果。方法选取2015年1月至2017年1月内蒙古自治区人民医院接受治疗的16例难治复发性老年多发性骨髓瘤患者,均给予三氧化二砷联合沙利度胺、地塞米松治疗4个疗程,观察患者治疗前后血红蛋白含量、骨髓浆细胞比例、免疫球蛋白定量、血游离轻链等指标。结果16例患者平均血红蛋白含量上升、骨髓浆细胞比例下降、免疫球蛋白定量下降,采用国际骨髓瘤预后评定标准,部分缓解明显(VGPR)2例(12.50%),部分缓解(PR)4例(25.00%),微小缓解(MR)3例(18.75%),疾病稳定(PD)3例(18.75%),进展4例(25.00%),总缓解率56.25%,总有效率75.00%。治疗期间未出现严重血象下降、严重感染及中断治疗的情况。结论三氧化二砷联合沙利度胺、地塞米松治疗老年难治复发性多发性骨髓瘤患者的临床效果显著。

Objective To investigate the effects of arsenic trioxide,dexamethasone and thalidomide on elderly patients with refractory andrelapsed multiple myeloma.Methods Totally 16 cases ofelderly patients with refractory and relapsed multiple myeloma treated in Inner Mongolia People’s Hospitalfrom January 2015 to January 2017 were enrolled and treated with arsenic trioxide combined with thalidomide and dexamethasone for four courses.The indicators such as hemoglobin,bone marrow plasma cell ratio,immunoglobulin quantification and blood free light chain were observed before and after treatment.Results The average hemoglobin content was increased,the proportion of bone marrow plasma cells was decreased,and the immunoglobulin level was decreased in 16 cases of patients.Using international standards for prognostic assessment of multiple myeloma,two cases(12.5%)were very good partial remission,four cases(25.00%)were partial remission,three cases(18.75%)were minimal remission,three cases(18.75%)were stable disease and four cases(25.00%)were progressed.The total effective rate was 75.00%.There were no severe hemogram decline,severe infection and interruption during treatment.Conclusion The treatment of arsenic trioxide combined with thalidomide and dexamethasone is effective for elderly patients with refractory and relapsed multiple myeloma.