小剂量沙利度胺联合COMP方案治疗多发性骨髓瘤的疗效分析

Analysis on curative effects of multiple myeloma using small dose of thalidomide and chemotherapy

目的观察小剂量沙利度胺联合COMP方案治疗多发性骨髓瘤（MM）的疗效及不良反应，对比其与单纯COMP方案疗效的差异。方法分析42例初治和27例难治复发性MM应用小剂量沙利度胺联合COMP方案的总有效率和不良反应；分析应用两种治疗方案对患者M蛋白、骨髓浆细胞比例和血红蛋白改善情况。结果42例初治MM，单用COMP22例，联合应用小剂量沙利度胺20例，总有效率分别为40．91％和70．00％，两者差异有统计学意义；27例难治复发MM，单用COMP组13例，联合应用14例，总有效率分别为42．86％和84．62％，两者相比差异有统计学意义。应用沙利度胺不良反应轻，患者可以耐受。联合治疗组可以明显提高患者血红蛋白含量、降低血浆M蛋白浓度和骨髓浆细胞比例。结论小剂量沙利度胺联合COMP方案可以提高初治和难治复发MM的总有效率，不良反应轻。

Objective To study the curative effects and adverse effects of the thalidomide combined with COMP chemotherapy in treating multiple myeloma （MM）. Methods 42 patients were initially diagnosed as MM and 27 patients were refractory and relapsed MM. The small dose of thalidomide combined with COMP management and COMP management alone were used. The effective rate and adverse effects were analyzed. Changes of M-protein in serum, percentage of plasma cells in bone marrow and the level of hemoglobin were also analyzed in both pre-treatment and post-treatment periods. Results In 42 patients who were initially diagnosed as MM, the effective rate was 40.9 % for 22 patients treated by chemotherapy alone and 70.0 % for 20 patients treated by the thalidomide combined with chemotherapy. Statistic difference was observed between those two group. As to the 27 patients who were refractory and relapsed MM, the effective rate was 42.9 % for 13 patients treated by chemotherapy alone and 84.6 % for 14 patients treated by the thalidomide combined with chemotherapy. Statistic significance was present between them. Adverse effects were less and tolerated. Conclusion Treatment of small dose of thalidomide combined with COMP chemotherapy could significantly improve the effective rate with less adverse effects.