乌苯美司联合TMP方案治疗多发性骨髓瘤的疗效观察

Efficacy of UBT and TMP Regimen in the Treatment of Multiple Myeloma

目的探讨乌苯美司联合TMP方案治疗多发性骨髓瘤(MM)的有效性及安全性。方法将2010年1月至2015年5月在本院治疗的60例MM患者按随机数字表法分为2组,每组30例,A组给予沙利度胺+马法兰+强的松(TMP)方案化疗,B组在TMP方案的基础上加乌苯美司30 mg·d-1,持续治疗6个月,比较两组的治疗效果。结果治疗后B组Ig G、Ig A及骨髓瘤细胞均显著低于A组(P<0.05)。A组ORR为63.33%,B组为86.67%;A组PFS为(14.35±0.47)月,B组为(16.45±0.71)月,两组比较差异均有统计学意义(P<0.05)。B组骨髓抑制发生率显著低于A组(P<0.05),两组其余毒副反应发生率比较,差异无统计学意义(P>0.05),但B组3~4级毒副反应发生率均显著低于A组(P<0.05)。结论对多发性骨髓瘤患者在TMP化疗的基础上加用乌苯美司,可提高患者缓解程度,延长无进展生存期,减少骨髓抑制发生率,并减轻毒副反应程度。

Objective To investigate the efficacy and safety of UBT and TMP regimen in the treatment of multiple myeloma （MM）. Methods 60 patients with MM who were treated between January 2013 and May 2015 were divided into two groups according to the random number table, 30 cases in each group. Group A was treated with thalidomide＋melphalan＋prednisone （TMP） regime, and group B was treated with UBT 30 mg.d-1, based on TMP chemotherapy. After continued treatment for 6 months, we compared treatment effect of the two groups. Results After treatment, the IgG, IgA and myeloma cells in group B were lower than those in group A （P〈0.05）. The ORR was 63.33% in group A, but 86.67% in group B. The PFS of group A was （14.35± 0.47） months, but that of group B was （16.45 ± 0.71） months. There were significant differences in ORR and PFS between the two groups （P〈0.05）. The incidence of bone marrow suppression was lower in group B than in group A （P〈0.05）. The incidence of other adverse reactions was not statistically different between the two groups （P〈0.05）, but the incidence of grade 3 - 4 adverse reactions were lower in group B than in group A （P〈0.05）. Conclusion TMP chemotherapy combined with ubenimex can improve the degree of remission, prolong progression-free survival, reduce bone marrow suppression, and reduce the degree of adverse reaction in patients with multiple myeloma.