多发性骨髓瘤患者和厚朴酚联合三氧化二砷治疗前后血清β_2-MG及LDH的变化

Changes of serum β_2-MG and LDH in combination therapy of multiple myeloma with honokiol and arsenic trioxide

目的探讨多发性骨髓瘤(MM)患者应用和厚朴酚(HNK)联合三氧化二砷(As_2O_3)治疗前后血清β_2-微球蛋白(β_2-MG)及乳酸脱氢酶(LDH)的变化。方法选取35例确诊为MM的患者,在标准VAD治疗方案(长春新碱+阿霉素+地塞米松)的基础上,给予As_2O_3联合HNK进行治疗。分别于治疗前和治疗后4、8、12周检测患者静脉血血红蛋白、M蛋白、β_2-MG和LDH浓度及骨髓浆细胞比例。结果随着治疗时间的延长,MM患者的缓解率、控制率明显增加。治疗后12周,MM患者的缓解率、控制率明显高于治疗后4周及治疗后8周(P<0.05);而治疗后4周的缓解率、控制率与治疗后8周比较,差异无统计学意义(P>0.05)。MM患者治疗后4、8、12周的血红蛋白浓度明显高于治疗前(P<0.05),M蛋白浓度、骨髓浆细胞比例及血清β_2-MG、LDH浓度均明显低于治疗前(P<0.05),且治疗后不同时间段各指标比较差异均有统计学意义(P<0.05)。结论在标准VAD治疗方案的基础上,联合应用HNK与As_2O_3可明显降低MM患者血清β_2-MG及LDH浓度。

Objective To investigate the changes of serum beta2-microglobulin(β_2-MG)and lactate dehydrogenase(LDH) in multiple myeloma(MM) patients before and after the treatment with a combination of honokiol(HNK)and arsenic trioxide(As_2O_3). Methods A total of 35 patients diagnosed as MM were enrolled. They were treated with As_2O_3 and HNK on the basis of VAD(vincristine+adriamycin+dexamethasone)treatment. The levels of hemoglobin,M protein,β_2-MG and LDH in venous blood and the proportions of plasma cells in bone marrow were determined before and after treatment for 4,8 and 12 weeks. Results Remission rate and control rate increased with treatment time. After treatment for 12 weeks,remission rate and control rate were higher than those after treatment for 4 and 8 weeks(P<0.05). There was no statistical significance for remission and control rates between 4 and 8 weeks after treatment(P>0.05). After treatment for 4,8 and 12 weeks,the levels of hemoglobin were higher than that before treatment(P<0.05),but the levels of M protein,β_2-MG and LDH and the proportions of plasma cells were lower than those before treatment(P<0.05),and there was statistical significance at different treatment time(P<0.05). Conclusions The combined treatment with HNK and As_2O_3 on the basis of VAD treatment can decrease the levels of β_2-MG and LDH in MM patients.