沙利度胺联合地塞米松治疗初治多发性骨髓瘤疗效观察

Clinical efficacy of thalidomide combined with dexamethnsone in treatment of previously untreated multiple myeloma.

目的 观察沙利度胺联合地塞米松方案治疗多发性骨髓瘤的疗效及其不良反应.方法 对18例初治多发性骨髓瘤患者进行沙利度胺联合地塞米松治疗,沙利度胺治疗起始量为100 mg/d,每晚口服,根据患者耐受情况逐渐加量,每周增加100 mg/d,直到400 mg/d维持治疗;地塞米松40 mg/d,第1～4日,第9～12日,第17～20日分别静脉或口服给药,每28日为1个疗程.该方案治疗至少3个月.结果 完全缓解2例（11%）,部分缓解4例（22%）,进步8例（45%）,无效4例（22%）,总有效率78%.常见的不良反应为便秘、嗜睡、疲乏、水肿、指端麻木等.结论 沙利度胺联合地塞米松是治疗初治多发性骨髓瘤的有效治疗方案,不良反应少,耐受性好.

Objective To assess the clinical efficacy and side effects of thalidomide in combination with dexamethasone in the treatment of previously untreated patients with multiple myeloma （ MM ）. Methods Eighteen MM patients were treated with thalidomide combined with dexmethasone. Thalidomide was given orally at an initial dose of 100 mg/d once per night, and then gradually increased to the maximum dose of 400 mg/d at a rate of 100 mg/d per week, according to individual tolerance. Dexamethasone was given at 40 mg/d either orally or intravenously on days 1 -4,9 - 12 and days 17 -20. All patients were treated at least for 3 cycles, with twenty-eight days as a cycle. Results The overall efficacy of the 18 patients was 78% ,among which,2 cases achieved complete remission （CR） （11%） ,4 cases achieved partial remission （CR）（22% ）, and 8 cases had improvement （45%） ,while 4 cases had no effect （22%） .The main side effects included constipation, hypersomnia, fatigue and acroanesthesia. Conclusions The combination of thalidomide with dexamethasone is effective in patients with previously untreated MM,with slight side effects and high tolerance.