48例复发或难治性骨髓瘤治疗与预后分析

Study on the treatment and prognosis of multiple myeloma: A report of 48 relapsed/refractory cases

目的:探讨不同治疗方法对复发或难治性多发性骨髓瘤预后的影响。方法:对48例复发或难治性多发性骨髓瘤进行了多种不同的分组治疗及长期随访,观察缓解率和生存期,并经统计学处理。结果:影响复发或难治性多发性骨髓瘤患者生存的主要因素是年龄>60岁(P<0.01)。在提高部分缓解率方面,三氧化二砷组优于联合化疗组和化疗加干扰素组,分别为31.2%、18.9%和21.8%(χ2=2.510,P<0.05)。三氧化二砷组的生存期较化疗组和化疗加干扰素组延长,分别为(15.67±3.42)个月、(11.74±4.39)个月和(12.93±3.62)个月(F=4.631,P<0.01),化疗组与化疗加干扰素组生存期差异无统计学意义。结论:在增加复发或难治性多发性骨髓瘤缓解率及延长生存期方面,三氧化二砷是一种较有希望的药物。

Objective:To analyze the influence of different means of treatment on the prognosis of relapsed or refractory multiple myeloma(MM). Method:48 cases of relapsed or refractory MM were treated in different means, and the prognosis and remission rate and survival of these cases were analyzed in long term follow-up. Result:The survival time was significantly shorter in patients with relapsed or refractory MM in ages ≥60 (P<0.01). In the aspects of increasing part remission rate, arsenic trioxide contains more advantage than group of chemotherapy or chemotherapy +IFN-α, 31.2% vs 18.9% and 21.8% (χ2=2.510, P<0.05). The survival time was prolonged in group of arsenic trioxide than those in groups of chemotherapy and chemotherapy +IFN-α, 15.67±3.42 months vs 11.74±4.39 months and 12.93±3.62 months (F=4.631, P<0.01). No difference of survival time between group of chemotherapy and chemotherapy +IFN-α had been observed. Conclusion:In treatment of relapsed or refractory MM, the arsenic trioxide is a hopeful medicine which, can increase CR rate and prolongation of survival time.