反应停联合VPD方案治疗难治及复发性多发性骨髓瘤疗效及VEGF水平变化

The clinical effects of thalidomide combined with VPD program therapy in refractory and relapsed multiple myeloma and the change of serum VEGF levels

目的:评价反应停联合VPD方案治疗难治及复发性多发性骨髓瘤(MM)的临床疗效并测定反应停联合VPD方案治疗前后血清VEGF水平的变化。方法:用前瞻性设置对照的研究方法将纳入研究的48例难治及复发性MM病例分为治疗组与对照组,治疗组予以反应停400～600mg/d,每4～5周联合VPD方案一次,3至6月后作评价;对照组单纯予以VPD方案。两组治疗前和治疗后3月与6月分别测定患者血清中血管内皮生长因子(VEGF)水平。用统计软件STATA5.0采用卡方检验完成全部统计分析。结果:治疗组24例,总有效率83.33%,对照组24例,总有效率54.17%(P【0.05)。治疗组24例患者在反应停参与治疗前血中VEGF水平为376.21±20.35pg/ml、治疗后3月为238.52±14.23pg/ml(P【0.05)、治疗后6月为149.78±10.36pg/ml(P【0.01)。对照组24例患者治疗前血中VEGF水平为377.97±19.22pg/ml、治疗后3月368.19±19.57pg/ml(P】0.05)、治疗后6月为357.83±18.99pg/ml(P】0.05)。结论:反应停联合VPD方案治疗难治及复发性多发性骨髓瘤疗效较好,副作用较小,可明显降低多发性骨髓瘤患者血清VEGF水平。

Objective:To evaluate the effectiveness and side-effects of thalidomide combined with VPD program on the treatment of refractory and relapsed multiple myeloma(MM) and to test the leveles of the serum vascular endothelial groth factor(sVEGF) of patients with refractory and relapsed multiple myeloma(MM) before and after treatment with thalidomide combined with VPD program.Methods:Ways to use forward-looking set ofcontrol methods will be incorporated into the study of 48 cases of refractory and relapsed MM patients divided into treatment group and control group, treatment group Thalidomide be 400-600mg /d,every 4～5 weeks once the joint VPD program,March to June after the evaluation;the control group simply be VPD program.The two groups before treatment and after treatment in March and June were measured in serum of patients with vascular endothelial growth factor(VEGF) levels.Using statistical software using chi-square test STATA5.0 to complete a full statistical analysis.Results:In the treatment group 24 cases,the total effective rate 83.33%,in the control group 24 cases,the total effective rate 54.17%(P<0.05).Treatment group,24 cases of thalidomide in patients with participation in the pretreatment serum VEGF level of 376.21 ± 20.35pg/ml,after treatment in March to 238.52 ±14.23pg/ml(P<0.05),after treatment in June for 149.78± 10.36pg/ml(P<0.01).Control group,24 cases of patients with pretreatment serum VEGF level of 377.97±19.22pg/ml,after treatment in March 368.19±19.57pg/ml(P>0.05),after treatment in June for 357.83±18.99pg/ml(P>0.05 ).Conclusion:thalidomide combined with VPD program on the treatment of refractory and relapsed multiple myeloma effect is better,less side-effects;can be significantly reduced in patients with multiple myeloma serum VEGF levels.