MPT及MP方案治疗多发性骨髓瘤疗效比较

Comparison of the Effects of MPT and MP Regimen for the Treatment of Multiple Myeloma

[目的]观察MPT方案与单用MP方案治疗42例初发多发性骨髓瘤（MM）的近期疗效.[方法]MPT组20例,沙利度胺100 mg/d开始口服,1周后加量为200 mg/d,长期口服维持;马法兰8 mg/（m2·d）,口服,d1～4;强的松60 mg/（m2·d）,d1～4,每4周重复.MP组22例,马法兰＋强的松用法同MPT组.两组均治疗4个疗程后判断疗效.[结果]①有效率MPT组高于MP组（分别为60.0%和27.3%,P〈0.05）.②MPT组治疗前后M蛋白、骨髓瘤细胞比例、血红蛋白变化差异均有显著性（均为P〈0.05）.MP组治疗前后骨髓瘤细胞比例、血红蛋白变化差异有显著性（均为P〈0.05）.MPT组治疗后M蛋白明显低于MP组（P〈0.05）.③20例采用小剂量沙利度胺治疗者不良反应轻微,均可耐受.[结论]小剂量沙利度胺联合MP方案不仅近期疗效优于单用MP方案,而且耐受性好,是一有效的MM治疗方案.

[Objective] To explore the short-term effect of MPT（melphalan＋ prednisone＋thalidomide） regimen vs MP（melphalan＋prednisone） regimen for the treatment of primary multiple myeloma patients. [Methods] A total of 42 multiple myeloma patients were divided into MPT group and MP group. MPT group（ n =20） were initially o- rally administered thalidomide 100mg/d, then one week later orally administrated thalidomide 200 mg/d for long, and also given melphalan 8 mg/m2 and prednisone 60 mg/mz daily for 4 days at a interval of 4 weeks. MP group（ n = 22） only received melphalan and prednisone. After 4 courses of treatment, the effects of the two groups were evaluated. [Results] The total response rate was 60.0% and 27.3% in the MPT group and the MP group, respectively, and there was significant difference between two groups（ P 〈0.05）. The M-protein, myeloma cells and the serum Hb improved significantly（ P 〈0.05, respectively） after treatment in the MPT group. In the MP group myeloma cells and the serum Hb were to get better after treatment（ P〈0.05, respectively）. Toxicities were mild, and can be tolerated or be manageable in twenty patients treated with low dose of thalidomide. [Conclusion] Low dose of thalidomide combined with MP regimen is not only more effectively than MP regimen alone, but also toxicities can be tolerated, so it is an effective therapy.