复方黄黛片联合沙利度胺治疗难治或复发多发性骨髓瘤临床观察

Effects of Compound Huangdai Tablets combined with Thalidomide in treatment of refractory / relapsed multiple myeloma: a clinical observation

目的：观察复方黄黛片联合沙利度胺治疗难治或复发多发性骨髓瘤的有效性及安全性。方法：11例复发或难治的多发性骨髓瘤患者采用复方黄黛片联合沙利度胺治疗,复方黄黛片1.35~2.5 g/次,一天三次,连续口服14天,停用14天;同时给予沙利度胺口服,起始剂量为100 mg/d,一周后逐步加量调整至100~150 mg/d,28天为1个疗程。两药连用3个疗程后评价疗效,观察其有效性和不良反应。结果：11例患者中,完全缓解（CR）1例,很好的部分缓解（VGPR）2例（18.2%）,部分缓解（PR）5例（45.5%）,病情稳定（SD）2例（18.2%）,病情进展（PD）1例（9.1%）,总有效率（ORR）72.7%。不良反应主要食欲下降、恶心、嗜睡、乏力、便秘等,可对症处理后缓解;中性粒细胞减少为1~3级,经相应处理后好转。结论：复方黄黛片联合沙利度胺治疗难治或复发多发性骨髓瘤疗效好、不良反应少、使用方便。

Objective： To investigate the effects and safety of Compound Huangdai Tablets（ CHDT）combined with Thalidomide in the treatment of refractory / relapsed multiple myeloma（ MM）. Methods ： Eleven patients with relapsed / refractory MM were Treated with Compound Huangdai Tablets and thalidomide. The dosing of CHDT was 1. 35 ~ 2. 5 g / time,thrice daily,given continuously and orally for 14 days and then discontinued for 14 days. Meanwhile,all patients were given oral Thalidomide,with a starting dose of 100 mg / d. The dose of Thalidomide was adjusted to 100 ~ 150 mg / d gradually after one week for a course of 28 days. The treatment outcome was evaluated,and the efficacy and adverse reactions were observed after 3 continuous courses of CHDT and Thalidomide. Results： In the 11 patients,there was 1 with complete remission（ CR）,2 with very good partial response（ VGPR）（ 18. 2%）,5 with partial remission（ PR）（ 45. 5%）,2 with stable disease（ SD）（ 18. 2%）,and 1 with disease progression（ PD）（ 9. 1%）. The overall response rate（ ORR） was 72. 7%. The main adverse reactions were anorexia,nausea,drowsiness,fatigue,and constipation,which were alleviated after symptomatic treatment. The severity of neutropenia was grades 1 ~ 3,which were improved after treatment.Conclusion： Compound Huangdai Tablets and Thalidomide show good effects, few adverse reactions, and convenient use in the treatment of refractory / relapsed MM.