改良VAD联合马法兰治疗多发性骨髓瘤的临床研究

The Clinical Study on the Freatment of Multiple Myeloma lombined by the VDA Regimen and Malphalan

目的 :探讨治疗多发性骨髓瘤 (MM)更有效的方案。方法 :随机把 40例病人分成 A、B两组 ,A组病人采用 VDA方案治疗 ,B组病人采用 MVDA方案 ,观察两种疗效和毒副作用。结果 :A、B两组均有 13例 MM患者完成 MVDA和 VDA两种方案治疗。MVDA方案治疗 1个疗程后 ,完全缓解 (CR) 2例 (15 .4% ) ,部分缓解 (PR) 7例 (47.8% ) ,有效率为 6 9.2 % ;VDA方案 13例治疗 1个疗程后 ,CR 0例 ,PR 3例 ,有效率 2 3.1%。两种方案差异显著 (P <0 .0 5 )。 MVDA方案导致粒细胞下降率、血小板下降率均比 VAD方案高 (P <0 .0 5～ 0 .0 1) ,但副作用均在停药后 2周内恢复 ,未见永久性造血干细胞损害和治疗相关性死亡。结论 :MVDA方案治疗 MM疗效高 ,副作用较少 ,持续时间短 ,病人可以承受 。

Objective:To explore more effective treatment regimen for multiple myeloma (MM).Methods:Randomized clinical trial was conducted to determine whether the outcome of MM patients treated with the MVDA regimen was better than that with VDA regimen.Results:The remission rate of cases treated with MVDA regimen ( 60.8 %) was significantly higher than that of cases treated with VDA regimen ( 23.5 %) (P< 0.025 );The granulocyte decreasing (GD) rate and platelet decreasing (PD) rate of cases treated with MVDA regimen were higher than that of cases treated with VDA regimen,but the time of the GD and the time of the PD were shorter than 2 weeks.Conclusion:The treatment outcome of MM was better with MVDA regimen than that with VDA regimen,The MVDA is a effective treatment regimen for MM.