T-CEMD方案治疗多发性骨髓瘤的临床研究

The Clinicl Study of T-CEMD Regimen in the Treatment of Multiple Myeloma

目的探讨T-CEMD方案治疗多发性骨髓瘤(MM)的临床疗效和不良反应。方法 22例复发难治性MM患者应用T-CEMD方案:沙利度胺100mg,每晚1次;环磷酰胺500mg/m2,第1天;足叶乙甙70mg/m2,第1～2天;米托蒽醌4mg/m2,第1～3天;地塞米松40 mg第1～4天;21d为一个疗程。19例初治MM用T-CEMD与VAD类方案交替(T-CEMD/VAD)治疗;18例初治MM单用VAD类方案治疗。结果 在22例难治性MM患者中,完全缓解(CR)8例(36%)、部分缓解(PR)12例(55%)、无效(NR)2例(9%),总有效率(ORR)91%。T-CEMD/VAD方案治疗的19例中,CR 6例(32%)、PR11例(58%)、NR 2例,总有效率(ORR)90%。单用VAD类方案治疗18例初治MM者中,CR 1例(6%)、PR 8例(44%),ORR50%。T-CEMD方案的主要不良反应为骨髓抑制。结论 T-CEMD方案对复发难治性MM患者中的补救治疗,具有较为理想的疗效。T-CEMD/VAD交替方案治疗初治MM患者,明显优于单用VAD类方案。

Objective To investigate the efficacy and adverse effects of T-CEMD regimen in the treatment of multiple myeloma （MM）. Methods Twenty-two patients with refractory or relapsed MM were treated by T-CEMD regimen;19 patients with MM were treated by T-CEMD/VAD regimen;18 patients with MM were treated by VAD like regimen. Results Out of 22 patients with refractory or relapsed MM were treated by T-CEMD regimen,8 achieved CR,12 achieved CR,ORR were 91%（20/22）;Out of 19 patients with MM were treated by T-CEMD/VAD regimen,6 achieved CR,11 achieved CR,ORR were 90%（17/19）;Out of 18 patients with MM were treated by VAD like regimen,1 achieved CR,8achieved CR,ORR were 50%（9/18）. The main toxicities of T-CEMD regimen Were marrow depressed. Conclusion The T-CEMD regimen is more effective treatment to patients with refractory or relapsed MM; The T-CEMD/VAD regimen is an very effective way as induction treatment in new-diagnosed MM.