VAD方案联合沙利度胺及干扰素治疗多发性骨髓瘤疗效观察.doc

VAD方案联合沙利度胺及干扰素治疗多发性骨髓瘤疗效观察【摘要】 目的 观察VAD 方案联合沙利度胺和干扰素治疗多发性骨髓瘤的临床疗效和不良反应。方法 17例多发性骨髓瘤均采用VAD 方案联合沙利度胺和干扰素治疗。沙利度胺的起始剂量为100 mg/d,每周增加50 mg,直至剂量增加至200 mg/d。干扰素为300万单位/d,隔日1次。21 d为1 周期。治疗2 个周期后,根据血象、血清M 蛋白、骨髓瘤细胞等指标来判断疗效,分为部分缓解、疾病稳定和疾病进展。结果 部分缓解14例,疾病稳定2例,疾病进展1例,总有效率82.35%。主要不良反应有嗜睡、便秘、头晕、心动过缓和发热,但都能耐受。结论 VAD 方案联合沙利度胺和干扰素治疗多发性骨髓瘤具有疗效高和耐受性好的优点,值得进一步的临床观察和推广。 【关键词】多发性骨髓瘤;VAD方案;沙利度胺;干扰素 VAD regimen combined with thalidomide and interferon in treatment of multiple myeloma QIN Fu li,GUO Zhi qiang.The Central Hospital of Zheng Zhou City,Zhengzhou 450007,China 【Abstract】 Objective To observe the efficacy and side effects ofVAD regimen combined with thalidomide and interferon in treatment of multiple myeloma.Methods 17 patients with multiple myeloma were administrated with VAD regimen combined with thalidomide and interferon.The initial dose of thalidomide was 100 mg/d,then increased 50 mg per week till 200 mg/d.The dose of interferon was 3×10?6 μ/d.The therapeutic effectiveness was classified into partial remission,stabilization and progression according to the change of peripheral blood counts,serum M protein,and bone marrow myeloma cells.Results The total efficiency rate was 82.35%(14 cases of partial remission).The main side effects were sleepiness,constipation,dizzy,bradycardia and fever,which all were tolerable.Conclusion The merits of VAD regimen combined with thalidomide and interferon in treatment of multiple myeloma are significant response rate,less side effects,good tolerance and safety.It is worthy for clinical investigation and widespread generalization. 【Key words】 Multiple myeloma;VAD regimen;Thalidomide; Interferon 多发性骨髓瘤(MM)是一种比较常见的浆细胞克隆增殖性疾病,国内外采用VAD 方案治疗,取得了较好效果;血管生成抑制剂沙利度胺是近年来治疗MM 的研究热点;干扰素抑制瘤细胞生长增殖,刺激NK细胞活性,可提高化疗缓解率。本科采用VAD 方案联合沙利度胺和干扰素治疗初发和复发难治的多发性骨髓瘤17例,取得了较好疗效。现报告如下。 1 材料与方法 1.1 临床资料 本文中所有病例均为本院2003年8月至2007年10月住院的多发性骨髓瘤患者,全部均经临床、血清蛋白电泳或免疫电泳、X 线检查、骨髓检查等确诊,均符合多发性骨髓瘤的诊断标准[1]。所有病例均按Durie Salmon 分期标准进行分期。本组病例17例,其中男11例、女6例。最大年龄78岁,最小年龄42