PAD方案治疗75例初诊多发性骨髓瘤疗效观察

Efficacy Evaluation of PAD Regimen for the Patients with Newly Diagnosed Multiple Myeloma

目的:PAD方案已成为目前多发性骨髓瘤(MM)治疗的一线方案,国内外就其疗效和不良反应发生均有报道,本实验旨在观察并探讨PAD方案治疗我中心初诊多发性骨髓瘤患者的疗效和不良反应,为临床工作提供参考。方法:我科75例初诊多发性骨髓瘤患者给予PAD方案4-6疗程,评估疗效及不良反应。结果:75例患者接受PAD方案化疗,四疗程后总有效率(CR+VGPR+PR)为73.3%,其中CR 5例,占6.7%,VGPR 12例,占16%,PR 38例,占50.7%;无效例数为20例,占26.7%,其中SD 17例,占22.7%,PD 3例,占4%;1年总生存率为75%,2年总生存率为62.7%。血液学不良反应有白细胞降低34例(45.3%),血小板降低10例(13.3%);非血液学不良反应有周围神经系统症状25例(33.3%),疱疹病毒感染7例(9.3%),消化系统症状15例(20%),乏力14例(18.7%),呼吸系统症状29例(38.7%),激素相关症状3例(4%)。绝大部分患者可以耐受且完成相应化疗疗程。结论:我中心PAD方案疗效令人满意,不良反应可耐受,同国内外报道的疗效反应率相近,不良反应发生率更低,是治疗多发性骨髓瘤的首选方案。

Objective： PAD regimen has become the first-line therapy of multiple myeloma （MM）, and scientis all over the world have reported its efficacy and adverse reactions. This study aimed to investigate and explore the efficacy and adverse reactions of PAD regimen in patients with newly diagnosed multiple myeloma in our center, and to provide reference for clinical work. Methods： 75 patients with newly diagnosed multiple myeloma in our department were treated with 4-6 PAD treatment program. The efficacy and adverse reactions were evaluated. Results： After PAD regimen treatment for 4 courses, the overall response rate （CR ＋ VGPR ＋ PR） was 73.3%, including 5 cases of complete response （6.7%）, 12 cases of good partial response （16%）, 38 cases of partial response （50.7%）; There were 20 invalid cases （26.7%）, including 17 cases of SD （22.7%） and 3 eases of PD （4%）; overall survival rate of one year was 75%, and the overall survival rate of two years was 62.7%. Hematologic adverse reactions included 34 cases of leukopenia （45.3%）, 10 cases of thrombocytopenia （13.3%）; non-hematologic adverse reactions included 25 cases of peripheral nervous system symptoms （33.3%）, 7 cases of herpes virus infection （9.3%）, 15 cases of digestive symptoms （20%）, 14 cases of fatigue （18.7%）, 29 cases of respiratory symptoms（ 38.7% ）, 3 cases of hormone -related symptomst（4%）. The majority of patients were able to tolerate and complete the chemotherapy. Conclusion： The efficacy of P.AD regiment in our center was satisfactory, and the adverse reactions could be tolerated, and compared with reports at home and abroad, we had the same efficacy and less adverse reactions, so it was the first choice in the treatment of multiple myeloma.