血浆置换术联合化疗治疗老年多发性骨髓瘤的疗效及安全性

Efficacy and Safety of the Plasma Exchange for the Treatment of Multiple Myeloma in Elderly Patients

目的:观察血浆置换(PE)术治疗老年多发性骨髓瘤(MM)的疗效与安全性。方法:用CobeSpectraTM血细胞分离机对20例老年MM患者行PE联合化疗治疗,对照组8例仅给予化疗治疗。测定治疗前后球蛋白(GLB)、单克隆免疫球蛋白(M蛋白)、肌酐(CR)、尿酸(UA)和血红蛋白(HB)。比较两组治疗前后疗效及并发症发生情况。结果:PE联合化疗组较对照组治疗后GLB、M蛋白、CR和UA均显著下降(P<0.05);头晕、感染、出血、肾功能改善,但两组疗效比较无显著差异(P>0.05)。结论:血浆置换术联合化疗能迅速降低GLB和M蛋白水平,并改善临床症状和肾功能,但总有效率较单纯化疗无明显提高。

Objective：To study the efficacy and safety of the plasma exchange （PE） combined with standard chemotherapy for the multiple myeloma（MM） in elderly patients. Methods： Twenty-eight elderly patients with MM were assigned into two groups. The study group （20 cases） were give plasma exchange by CobeSpectraTM blood cells separator combined with chemotherapy. The control group（ 8 cases） were given chemotherapy only. Blood globulin（OLB）, M proteinum,creatinine （CR）, uric acid （UA） and hemoglobin （HB） were measured before and after therapy. Clinical symptoms and potential complications were monitored. Results： The levels of GLB, M proteinum, CR and UA were decreased significantly in the study group compared with the control group（P〈0.05）. Clinical symptoms were obviously relief and renal functions were improved in both groups, but there was no statistical significance between the two groups（P〉0.05）. Conclusion.. It has the advantages of clinical symptoms and renal function significantly by the plasma exchange combination chemotherapy in the cases suffered MM, however, it has not ascendancy obviously in total effective rate by the plasma exchange combined with chemotherapy.