来那度胺三氧化二砷及维生素C治疗复发难治性多发性骨髓瘤疗效分析.docVIP

来那度胺三氧化二砷及维生素C治疗复发难治性多发性骨髓瘤疗效分析 　　[摘要] 目的 探讨来那度胺、三氧化二砷及维生素C治疗复发/难治性多发性骨髓瘤的疗效及安全性。 方法 回顾性分析2013年8月～2017年4月期间来我院治疗的43例复发/难治性多发性骨髓瘤患者的临床资料，依治疗方案分为治疗组（20例，来那度胺+三氧化二砷+维生素C方案）与对照组（23例，TD方案），比较两组疗效及安全性。 结果 治疗组化疗3周期后的总缓解率（65.0%）大于对照组的34.8%（P=0.048），且治疗组可以达到更深程度的缓解（P=0.034）；胃肠道反应、周围神经病变、骨髓抑制、血栓的累计发生率差异无统计学意义（P0.05）；治疗组感染、血压波动、血糖波动的累计发生率低于对照组，差异有统计学意义（P0.05）；治疗组心脏毒性的累计发生率高于对照组，但差异无统计学意义（P=0.098）。 结论 来那度胺、三氧化二砷及维生素C方案治疗复发/难治性多发性骨髓瘤疗效明显，具有耐受性好、不良反应轻的特点，对合并基础疾病的老年患者亦有较好的疗效。 　　[关键词] 来那度胺；三氧化二砷；维生素C；复发/难治性多发性骨髓瘤 　　[中图分类号] R733.3 [文献标识码] A [文章编号] 1673-9701（2018）02-0016-04 　　[Abstract] Objective To investigate the efficacy and safety of lenalidomide， arsenic trioxide and vitamin C in the treatment of relapsed/refractory multiple myeloma. Methods The clinical data of 43 patients with relapsed/refractory multiple myeloma treated in our hospital from August 2013 to April 2017 were retrospectively analyzed. The patients were divided into treatment group（n=20， lenalidomide+arsenic trioxide+vitamin C program） and control group（n=23， TD program）. The efficacy and safety between the two groups were compared. Results The total remission rate in the treatment group after 3 cycles of chemotherapy was 65.0%， which was significantly higher than that in the control group（34.8%， P=0.048）， and the treatment group could reach a deeper degree of remission（P=0.034）. There was no statistically significant difference in the cumulative incidences of gastrointestinal reactions， peripheral neuropathy， myelosuppression and thrombus （P0.05）. The cumulative incidence of infection， fluctuation of blood pressure and blood glucose in the treatment group was lower than that in the control group， and the difference was significant（P0.05）. The cumulative incidence of cardiotoxicity was higher in the treatment group than that in the control group， but the difference was not statistically significant （P=0.098）. Conclusion The lenalidomide， arsenic trioxide and vitamin C regimens are effective in the treatment of