小剂量沙利度胺联合VADM方案治疗多发性骨髓瘤临床研究.docVIP

小剂量沙利度胺联合VADM方案治疗多发性骨髓瘤临床研究 　　[摘要] 目的：评价小剂量沙利度胺联合VADM方案治疗多发性骨髓瘤的临床疗效及不良反应。方法：将40例多发性骨髓瘤患者分成两组，T-VADM 组22例，给予沙利度胺，起始剂量为50 mg QN，无不良反应则每周递增50 mg，最大剂量为200 mg QN；长春新碱 0.4 mg/d，持续静滴24 h，第1~4天；THP 10 mg/d，持续静滴24 h，第1~4天；地塞米松40 mg/d，静滴，第1~4天；马法兰8 mg/（m2?d），第1~4天，口服，28 d为1个疗程。VAD组18例，给予经典VAD方案。结果：治疗组4例CR，12例PR，3例MR，总有效率为86.4%，对照组无一例达CR，9例PR，MR 2例，总有效率为61.1%，两组疗效比较差异有统计学意义（P0.05）；不良反应，治疗组出现糖尿病、感染、消化性溃疡等严重不良反应较对照组明显减少，且没有出现严重的骨髓抑制。结论：小剂量沙利度胺联合VADM方案治疗多发性骨髓瘤疗效确切，副作用少，值得临床深入研究及推广应用。 　　[关键词] 沙利度胺；VADM方案；多发性骨髓瘤；不良反应 　　[中图分类号] R733.3[文献标识码] C[文章编号] 1674-4721（2011）06（b）-024-03 　　 　　Clinical study of the effect and side-effects in patients with multiple myeloma by the treatment of T?VADM 　　WU Yanping1, MO Jun2 　　1.Department of Hematology, Taishan Peoples Hospital, Guangdong Province, Taishan 529200, China; 2.Department of Laboratory, Taishan Peoples Hospital, Guangdong Province, Taishan 529200, China 　　[Abstract] Objective: To evaluate the efficacy and side effects of thalidomide combined with VADM in the treatment of initial multiple myeloma (MM). Methods: Forty cases with initial MM were randomly divided into two groups. The T-VADM group were 22 patients, treated with low dose thalidomide accompanied with VADM. Thalidomide 50 mg was given orally everynight with serial increments of 50-100 mg at weekly interval until 200 mg/d. VCR 0.4 mg/d d1-4, THP10 mg/d d1-4, Dexamethasone 40 mg/d, d1-4. Each cycle lasted for 28 days. The VAD group were 18 patients, treated with classical VAD. Results: In the study group, there were 4 cases in complete remission, 12 cases in partial remission and 3 cases in improvement. The overall response rate was 86.4%. In the control group, there was a partial response in 13 cases and improvement in 2 cases. The overall response rate was 61.1%. The overall response rate in two groups had significant difference (P0.05). And the side effects, such as diabetes mellitus, infection and peptic ulcer reduced obviously in the study group (P0.05). Conclusio