三氧化二砷联合沙利度胺治疗骨髓增生异常综合征的临床研究

Clinical Study of Arsenic Trioxide Combined with Thalidomide for Refractory Multiple Myeloma Myelodysplastic Syndrome

目的探讨三氧化二砷联合沙利度胺治疗骨髓增生异常综合征的临床疗效。方法选取20例MDS患者作为治疗组,以同期收治的16例MDS患者作为对照组,治疗组给以三氧化二砷联合沙利度胺治疗,对照组给予常规治疗,比较两组疗效。结果治疗组总有效率为90.00%,感染率为43.75%;对照组总有效率为50.00%,感染率为10.00%;两组总有效率比较χ2=10.36,P<0.05;两组感染率比较χ2=5.40,P<0.05;两组不良反应比较,无统计学差异(P>0.05),两组无疾病进展生存时间和总生存时间比较,观察组显著高于对照组(P<0.05);两组患者治疗后VEGF水平与治疗前比均较呈大幅度下降,差异显著(P<0.01);治疗后观察组患者VEGF水平下降幅度与对照组相比,差异显著(P<0.05)。结论三氧化二砷联合沙利度胺治疗骨髓增生异常综合征疗效较好,且感染率低,患者可耐受,不良反应轻,值得临床推广应用。

Objective To investigate the clinical efficacy of arsenic trioxide combined with thalidomide for myelodys- plastic syndrome. Methods 20 cases of MDS patients were selected as treatment group,and 16 MDS patients were selected as the control group. The treatment group was treated with arsenic trioxide combined with thalidomide treatment, and the control group was given conventional treatment, the efficacy of 2 groups was compared. Results The total effective rate in treatment group was 90% ,the infection rate was 43.75% ;the total effective rate in control group was 50% ,the infection rate was 10% ;the compared total efficiency of two groups was X2 ： 10.36, P 〈 0.05 ; the compared infection rates between two groups was X2 = 5.40,P 〈0.05 ;there was no significant difference on the comparison of adverse reactions between two groups （P 〉 0.05 ）, the progression-free survival and overall survival of the observation group was significantly higher than that of control group （P 〈 0.05） ;VEGF levels of 2 groups droped significantly after treatment,the difference was significant （P 〈 0. O1 ） ;there was a sig- nificant difference （P 〈 0.05） by comparing decline degree of the VEGF level of patients in the observation group with that in the control group after treatment. Conclusion The curative effect of arsenic trioxide combined with thalidomide for myelodyspias- tic syndrome is good, the infection rate is low,adverse reactions are light, and it is worthy of clinical application.