沙利度胺联合VAD方案治疗多发性骨髓瘤临床疗效研究

Thalidomide Combined with VAD Regimen of Multiple Myeloma Clinical Efficacy Studies

目的:对应用沙利度胺联合VAD方案治疗多发性骨髓瘤(MM)的临床疗效及不良反应进行评价。方法:将42例初诊为MM患者,采用随机数字表法分为2组行对比治疗,其中,对照组采用VAD方案,治疗组在对照组VAD化疗方案的基础上联合沙利度胺,沙利度胺起始剂量100mg.d-1,分早晚口服,每周递增50mg,最大剂量300mg.d-1。2组均治疗3个疗程。结果:经过3个疗程的治疗后,治疗组22例患者,部分缓解12例,总有效率77.3%;对照组20例,部分缓解4例,总有效率55.0%,2组有效率比较差异有显著性(P<0.05);在M-蛋白、骨髓浆细胞数及β2-微球蛋白等各项指标方面,2组与治疗前比较均有明显下降,而血红蛋白有显著上升,治疗组更为明显,差异有统计学意义(P<0.05);治疗后各项指标组间比较差异有显著性(P<0.05)。结论:较单用VAD方案,沙利度胺联合VAD方案在治疗多发性骨髓瘤的临床疗效上更为显著,且具有副作用少、耐受性好等优点,值得临床推广应用。

Objective： Thalidomide combined with VAD regimen of multiple myeloma （MM） clinical efficacy and adverse reactions were evaluated. Methods 42 patients with newly diagnosed MM patients, using a random number table is divided into two sets of line com- pared treatment, The control group VAD regimen, thalidomide in the treatment group on the VAD regimen the basis of the control group, Starting dose of thalidomide 100mg. d - 1, divided into morning and evening oral, Weekly increments 50mg, maximum dose 300mg. d -1. Two groups patients were treated for three course of treatment. Results：The treatmem group of 22 patients, partial remission in 12 ca- ses, The total efficiency of 77.3% ; The control group of 20 patients, partial remission in 4 cases, The total efficiency of 55%, Effective rates in the two groups had significant difference （ P 〈 0.05 ） ; IntheM - protein, bonemarrow plasma cells and β2 - microglobulin （ β2 - MG） and other indicators, Two groups were significantly decreased compared with those before treatment, treatment of various indexes of the difference between groups was significant （ P 〈 0.05 ）. Conclusion ： In contrast to the use of VAD regimen, thalidomide combined with VAD regimen in the treatment of multiple myeloma clinical curative effect is more obvious, Having few side effects, tolerance is good wait for an advantage, it is worthy of clinical application.