硼替佐米联合地塞米松与沙利度胺治疗多发性骨髓瘤的效果

EFFICACY OF BORTEZOMIB COMBINED BOTH DEXAMETHASONE AND THALIDOMIDE IN THE TREATMENT OF PATIENTS WITH MULTIPLE MYELOMA

目的比较硼替佐米+地塞米松+沙利度胺(BDT)方案与长春地辛+表柔比星+地塞米松+沙利度胺(VADT)方案治疗多发性骨髓瘤(MM)的临床效果。方法 MM病人67例,应用BDT方案治疗30例,VADT方案治疗37例,均治疗4个疗程,比较两组治疗前、治疗后β2-微球蛋白、免疫球蛋白、骨髓瘤细胞的变化,并比较两组疗效。结果 BDT组及VADT组化疗后β2-微球蛋白、免疫球蛋白、骨髓瘤细胞均低于化疗前,差异有显著性(t=2.837～7.562,P<0.05)。BDT组完全缓解(CR)占13.0%,接近完全缓解(nCR)占20.0%,部分缓解(PR)占53.0%,微小反应(MR)占6.7%,总有效率93.3%;VADT组CR占3.0%,nCR占10.8%,PR占40.5%,MR占16.2%,总有效率70.3%,两组疗效比较,差异有显著性(Hc=51.67,P<0.05)。结论 BDT方案治疗MM效果优于VADT方案,且起效快,可改善病人的预后。

Objective To compare the efficacy of bortezomib combined both dexamethasone and thalidomide （BDT） with vindesine＋epirubiein＋ dexamethasone＋thalidomide （VADT） in patients with multiple myeloma （MM）. Methods BDT the- rapy was used for 67 MM patients, and VADT for 37, a treatment of four courses was carried out in both groups. Changes of ~2- microglobulin, immunoglobnlin, and myeloma cells, before and after treatment, between the two groups were observed and com- pared. Results The levels of l？2-microglobulin, immunoglobulin, and myeloma ceils in both BDT and VADT after chemothera- py were lower than that before the treatment, the differences were statistically significant （t= 2. 837-7. 562, P〈0.05）. After four courses of therapy, in BDT group： complete remission （CR） 13. 0X, nearly complete remission （nCR） 20.0%, partial re- sponse （PR） 53.0%, and minimal remission （MR） 6.7%, total effective rate being 93.3% ; in VADT group： that were CR ac- counting for 3.0 %, nCR for 10.8%, PR for 40.5%, and MR for 16.2%, with a total effective rate of 70.3%. The differences between BDT and VADT were statistically significant （Hc=51. 67,P〈40.05）. Conelusion BDT is superior to VADT in the treatment of MM in terms of fast action and improvement of patients＇ prognosis.