环磷酰胺联合长春新碱阿霉素地塞米松治疗多发性骨髓瘤的安全性及可行性

Safety and feasibility of cyclophosphamide combined with Vincristine + Adriamycin + Dexamethason in the treatment of multiple myeloma

目的探讨环磷酰胺联合长春新碱+阿霉素+地塞米松(VAD方案)治疗多发性骨髓瘤的安全性及可行性。方法采取随机抽样的方法选取2009年1月至2014年9月间收治的96例多发性骨髓瘤患者,依据治疗方法将患者分为研究组和对照组,每组48例。对照组患者给予单纯VAD方案治疗,研究组患者给予环磷酰胺联合VAD方案治疗,对两组患者的各项指标、临床疗效及不良反应发生情况进行比较。结果研究组患者的骨髓瘤细胞、β2-微球蛋白、24 h尿液轻链和血清尿素氮水平均显著低于对照组,差异均有统计学意义(均P<0.05)。研究组的治疗总有效率为79.2%(38/48),显著高于对照组的45.8%(22/48),差异有统计学意义(P<0.05)。研究组和对照组患者的不良反应发生率分别为25.0%(12/48)和20.8%(10/48),差异无统计学意义(P>0.05)。结论环磷酰胺联合VAD方案治疗多发性骨髓瘤安全可行。

Objective To investigate the safety and feasibility of cyclophosphamide combined with Vincristine ＋ Adriamycin ＋ Dexamethason（ VAD） in the treatment of multiple myeloma. Methods From January 2009 to September 2014,96 multiple myeloma patients who were treated in The First Hospital of Yulin were selected by random sampling method,and they were divided into the study group（ n = 48） and the control group（ n = 48） according to the treatment methods. The control group were given VAD therapy alone,while the study group were given cyclophosphamide plus VAD regimen. Then the laboratory tests,clinical efficacy and adverse events of the two groups were analyzed. Results The myeloma cells,β2-microglobulin,24 h urine light chain,serum urea nitrogen levels of the study group were significantly lower（ P〈0. 05）. The total treatment efficiency [79. 2%（ 38 /48） ]was significantly higher than the control group [45. 8%（ 22 /48） ]（ P〈0. 05）. The adverse reactions of the two groups were 25. 0%（ 12 /48）,20. 8%（ 10 /48）,with no significant difference（ P〉0. 05）. Conclusion Cyclophosphamide combined with VAD in the treatment of multiple myeloma is safe and feasible.