CTD方案治疗难治或复发多发性骨髓瘤

The effect of cyclophosphamide, thalidomide and dexamethasone combination therapy in relapsed/refractory multiple myeloma

目的应用环磷酰胺、沙立度胺及地塞米松（CTD）方案治疗难治或复发多发性骨髓瘤（MM）。方法20例难治或复发MM患者接受沙立度胺，100～200mg／d，口服持续应用；环磷酰胺，200～300mg·m^-2·d^-1。1～4d，静脉注射；地塞米松，20～40mg／d，1～4d，1：3服。4周为1个疗程。3个疗程后，若出现疗效或病情稳定则再连续应用3个疗程；若病情进展，则停止治疗。结果3个疗程后，13例（65％）患者显示治疗反应，其中9例患者获部分缓解，4例患者获微小缓解。而5例患者病情稳定，2例进展。对病情未进展的18例患者继续治疗3个疗程后再次评价，则部分缓解13例（65％），获微小缓解5例。结论CTD是一个具有较好治疗前景的方案。

Objective To investigate the effect of the combination of thalidomide, cyclophosphamide and dexamethasone for the treatment of relapsed/refractory multiple myeloma. Methods 20 relapsed/refractory multiple myeloma patients received thalidomide （200 mg/d）, cyclophosphamide （300mg·m^-2·d^-1, d1-4, every 4 weeks） and pulsed dexamethasone （20-40 mg/d, dl-4, every 4 weeks）. Results After 3 cycles of therapy, 9 cases obtained partial remission （PR）, 4 had minimal responses（ MR）, 5 were of no change and 2 had progressive disease. After 6 cycles of therapy, 13 patients achieved PR and 5 had MR. Conclusion The combination of thalidomide, cyclophosphamide and dexamethasone is a premising treatment regime for relapsed/refractory multiple myeloma.