雷利度胺联合改良MP方案治疗老年多发性骨髓瘤患者的效果观察

Observation of lenalidomide combined with modified MP regimen in the treatment of elderly patients with multiple myeloma

目的 观察雷利度胺联合改良MP方案治疗多发性骨髓瘤（multiple myeloma，MM）的临床效果。方法 选择我院2013年1月至2016年1月确诊的老年MM 84例作为研究对象，应用随机数字表法将患者分为治疗组（42例）和对照组（42例）。治疗组患者选择LMP方案＋α2b-干扰素，对照组患者选择标准MPT方案，比较两组患者治疗前、后β2微球蛋白水平的变化，比较两组的总有效率。结果 治疗组和对照组患者治疗前β2微球蛋白比较差异无统计学意义（P〉0.05）；治疗后治疗组β2微球蛋白浓度为（3.11±0.28） mg/L，对照组为（4.75±0.36） mg/L，两组比较差异有统计学意义（t＝9.094，P〈0.05）；治疗组总有效率为83.33%（35/42），对照组为59.52%（25/42），两组比较差异有统计学意义（χ2＝5.833，P＝0.016）。治疗组患者不良反应发生率为9.52%，对照组为26.19%，两组比较差异有统计学意义（χ2＝3.977，P＝0.046）。结论 雷利度胺联合改良MP方案治疗老年MM的临床效果优于常规治疗方法，总有效率高，不良反应小。

Objective To investigate the clinical effect of lenalidomide combined with modified MP regimen in the treatment of multiple myeloma（MM）.Methods Eighty=four elderly multiple myeloma patients treated in Tangshan City Workers＇ Hospital from January 2013 December 2016 were enrolled in this study.The patients were randomly divided into treatment group （42 cases） and control group （42 cases）. The patients in the treatment group were given LMP regimen ＋ α2b- interferon.The patients in the control group received the standard MPT regimen.The changes of the level of β 2 microglobulin in the two groups before and after treatment were compared, and the total effective rate in the two groups was compared.Results No statistically significant difference was showed between the two groups in β 2 microglobulin before treatment （P〉0.05）. After treatment, β 2 microglobulin concentration in the treatment group was （3.11±0.28） and was （4.75±0.36） in the control group, there was significant difference between two groups （t=9.094, P〈0.05）; the total effective rate of the treatment group was 83.33%, 59.52% in the control group, there was significant difference between two groups （t=5.833, P=0.016）. The incidence of adverse reactions in the treatment group was 9.52%, the control group was 26.19%, and the two groups were statistically significant （t=3.977, P=0.046）.Conclusion The clinical effect of Lenalidomide combined with modified MP regimen in the treatment of MM is better than that of conventional treatment, the total effective rate is highwe, with less adverse reactions.