71例初治多发性骨髓瘤的回顾性分析

Retrospective Analysis of 71 Cases of Multiple Myeloma

本研究探讨不同化疗方案治疗初治的多发性骨髓瘤的疗效。回顾性分析我院接受标准化疗方案治疗的71例初治患者的疗效。结果表明:71例初治的多发性骨髓瘤患者中44例患者病情有不同程度的缓解,总有效率61.9%,CR+nCR率21.1%。M2治疗组21例中CR+nCR5例,PR7例,总有效率57.1%;MP治疗组8例中无CR+nCR,PR3例,总有效率37.5%;VAD治疗组30例中CR+nCR6例,PR13例,总有效率63.3%;硼替佐米联合化疗组12例中CR+nCR4例,PR6例,总有效率83.3%。71例患者中位疾病进展时间22.1个月,平均生存期29.5个月,3年和5年存活率分别为41.2%和20.6%。结论:对于初治MM患者,可根据患者临床特点、分型等选择治疗方案,硼替佐米为MM提供了一种新的治疗药物选择。

The aim of this study was to investigate the efficacy of different chemotherapy regimens in patients with multiple myeloma （MM）. The therapeutic effects of 71 MM patients receiving standard chemotherapy regimens were retrospectively analyzed and evaluated. The results showed that 44 out of 71 new-diagnosed MM patients gained remission in varying degree, tolal effective rate was 61.9%, in which the rate of complete remission （CR） plus nearly complete remission （nCR） was 21.1%. 21 MM patients received M2 regimen gained total effective rate of 57.1%, in which the CR plus nCR were found in 5 MM patients, and partial remission （PR） was observed in 7 MM patients. 8 MM patients received MP chemotherapy regimen gained total effective rate of 37.5%, in which the CR ＋ nCR was not found, but the PR was observed in 3 MM patients. 30 MM patients received VAD regimen gained total effective rate of 63.3%, in which CR ＋ nCR and PR were found in 6 and 13 MM patients respectively, 12 MM patients received combined bortezomib regimen gained total effective rate of 83.3%, in which CR ＋nCR and PR were found in 4 and 6 IVIM patients respectively. The median time of progression and the median time of survival in 72 1VIM patients were 22. 1 and 29. 5 months respectively. The 3 and 5 year survival rates in 72 MM patients were 41. 2% and 20. 6% respectively. In conclution, the chemotherapy regimen for new-diagnosed MM patients should be selected according to their clinical features and subtypes, the bortezomib-combined regimen may be considered as a new and effective regimen for MM patients.