VAD方案联合沙利度胺和干扰素治疗多发性骨髓瘤疗效观察

VAD regimen combined with thalidomide and interferon in treatment of multiple myeloma

目的观察VAD方案联合沙利度胺和干扰素治疗多发性骨髓瘤的临床疗效和不良反应。方法17例多发性骨髓瘤均采用VAD方案联合沙利度胺和干扰素治疗。沙利度胺的起始剂量为100mg／d，每周增加50mg，直至剂量增加至200mg／d。干扰素为300万单位／d，隔日1次。21d为1周期。治疗2个周期后，根据血象、血清M蛋白、骨髓瘤细胞等指标来判断疗效，分为部分缓解、疾病稳定和疾病进展。结果部分缓解14例，疾病稳定2例，疾病进展1例，总有效率82．35％。主要不良反应有嗜睡、便秘、头晕、心动过缓和发热，但都能耐受。结论VAD方案联合沙利度胺和干扰素治疗多发性骨髓瘤具有疗效高和耐受性好的优点，值得进一步的临床观察和推广。

Objective To observe the efficacy and side effects of VAD regimen combined with thalidomide and interferon in treatment of multiple myeloma. Methods 17 patients with multiple myeloma were administrated with VAD regimen combined with thalidomide and interferon. The initial dose of thalidomide was 100 mg/d, then increased 50 mg per week till 200 mg/d. The dose of interferon was 3 ×10^6 μ/d. The therapeutic effectiveness was classified into partial remission, stabilization and progression according to the change of peripheral blood counts, serum M protein, and bone marrow myeloma cells. Results The total efficiency rate was 82. 35% （14 cases of partial remission）. The main side effects were sleepiness, constipation, dizzy, bradycardia and fever,which all were tolerable. Conclusion The merits of VAD regimen combined with thalidomide and interferon in treatment of multiple myeloma are significant response rate,less side effects, good tolerance and safety. It is worthy for clinical investigation and widespread generalization.