VAD方案治疗多发性骨髓瘤疗效观察

The efficacy observation of VAD regimen in the treatment of multiple myeloma

目的评估VAD方案治疗多发性骨髓瘤(MM)的疗效。方法24例Ⅲ期MM,采用VAD方案,即长春新碱0.5mg/d(或长春地辛1￣2mg/d)缓慢静脉注射,第1～4天;多柔比星(或表柔比星)10￣20mg/d缓慢静脉注射,第1～4天;地塞米松40mg/d口服,第1～4天,第9～12天,第17～20天,28d为1疗程。连续应用2疗程以上评估疗效。观察项目包括:血清M蛋白、肝肾功能、尿蛋白、骨髓穿刺、血象等,记录毒副反应。MM疗效标准,分为完全缓解(CR)、部分缓解(PR)、未缓解(NR)。结果CR8例(33.3%),PR12例(50.0%),NR4例(16.7%),总有效率为83.3%。结论VAD方案治疗Ⅲ期MM的临床疗效显著,临床症状改善明显。

Objective To evaluate the clinical efficacy of VAD regimen in the treatment of multiple myeloma （MM）. Methods 24 patients with stage III multiple myeloma were treated with VAD regimen. VAD solution consisted of vincristine（VCR, 0.5 mg/d iv）, doxorubicin（ADR, 10-20 mg/d iv）, dexamethasone （Dex, 40 mg/d po）. One treatment course persisted 28 days. Two continuous treatment were considered evaluable. Observational content included results of serum myeloma protein（M-protein）; liver and renal function; proteinuria of 24-hours; bone marrow and peripheral blood et al. The side reactions were recorded. The clinical efficacy evaluation was divided into complete response（CR）, partial response（PR）, none response（NR）. Results 8 cases achieved CR （33.3 %）, 12 cases PR （50 %）, 4 cases no change （16.7 %）. Overall response rate was 83.3 %. Conclusions The prominent clinical efficacy was achieved with VAD regimen in stage III multiple myeloma. The clinical manifestation improved rapidly and significantly.