沙利度胺联合VAD方及干扰素治疗多发性骨髓瘤的临床研究

The Clinical Research of Thalidomide Incorporation with VAD and Interferon-αin Treatment of Multiple Myeloma

目的:探讨沙利度胺联合VAD方案及干扰素治疗多发性骨髓瘤(MM)的临床疗效及不良反应。方法:58例MM患者,随机分为VAD方案对照组:长春新碱加吡喃阿霉素加地塞米松;治疗组:VAD方案加沙利度胺及干扰素,沙利度胺起始剂量200mg/d,每2周增加50～200mg/d,至患者不能耐受或最高剂量不超过每日800mg,α-2b干扰素300万U肌注,3次/周,维持该剂量半年。结果:治疗组部分缓解12例(42.86%),进步11例(39.29%),无效5例(17.85%),总有效率82.14%(23/28),明显优于对照组(总有效率的57.14%)(P<0.05);能有效降低M蛋白,使骨髓瘤细胞下降,提升血红蛋白;治疗后MM患者血清血管内皮细胞生长因子(VEGF)水平明显下降,与对照组比较差异有统计学意义(P<0.01)。副反应程度均可耐受。结论:沙利度胺联合VAD方案及干扰素治疗MM具有副作用少、耐受性好、给药方便、疗效明显的优点,值得临床深入研究和推广应用。

Objective： To study the curative effect and side effect of thalidomide incorporation with VAD and Interferon- αin treatment of multiple myeloma. Methods： 58 multiple myeloma patients were randomly divided into VAD group,VAD plus thalidomide and Interferon-etrespectively, the beginning dose of thalidomide was 200mg/d, increased 50 to 200mg every 2 weeks till the intolerant dose or below 800mg/d,Interferon three times once a week, maintained for half a year. Results： The experimental group had 12 partial relief eases（42. 86% ） , 11 improved cases（ 39. 29% ） ,5 inefficacy cases（ 17.85% ） ,total efficacy rate was 82. 14% （23/28） , significantly higher than that in control group （with total efficacy rate 57. 14% ） （P 〈 0. 05 ） ; the experimental schema effectively brought down the Mprotein and the number of myeloma cells, raised hemoglobin level; the level of vascular endothelial growth factor（VEGF） in treatment group was significantly lower than that of control group （P 〈 0. 01 ） ;while the side effects were to lerable. Conclusion： Thalidomide and Interferon-αincorporation with VAD applied in multiple myeloma has merits such as less side effects, good tolerance,convenient administration and significant curative effect, it would be valuable to do clinical research and widespread popularization.