沙利度胺联合改良VAD方案治疗多发性骨髓瘤临床疗效观察

摘要

目的：观察沙利度胺联合改良VAD方案治疗多发性骨髓瘤（ MM）的临床疗效和不良反应。方法：MM患者79例，均给予沙利度胺联合改良VAD方案治疗。结果：第1疗程后79例患者中CR为12.66％（10/79），总有效率为77.22％（61/79）；3疗程后79例患者中CR为40.51％（32/79），总有效率为83.54％（66/79）。44例大于等于60岁患者中，CR为40.91％（18/44），总有效率为84.09％（37/44）。35例小于60岁患者中CR为40％（14/35），总有效率为85.71％（30/35），两组患者经统计学检验临床疗效无显著性差异（ P>0.05）。38例IgG型患者中CR为44.74％（17/38），总有效率为92.11％（35/38）。23例IgA型患者中CR为39.13％（9/23），总有效率为82.61％（19/23）。8例轻链型患者中CR为37.50％（3/8），总有效率为75.00％（6/8）。10例不分泌型患者中CR为30.00％（3/10），总有效率为70％（7/10）；各组患者经统计学检验临床疗效无显著性差异（ P>0.05）。结论：沙利度胺联合改良VAD化疗方案治疗MM完全缓解率及总有效率高，对不同分型及年龄组患者疗效均显著，值得进一步临床观察和推广。%Objective:To observe the therapeutic effect of thalidomide combined with modified VAD regimen for patients with multiple myeloma( MM). Methods:All of the 79 patients were newly diagnosed MM and were treated with thalidomide combined with modified VAD regimen. Results:After the first course,complete remission( CR)was achieved in 10 out of 79 patients,CR rate was 12. 66%(10/79),the total effective rate was 77. 22%(61/79). After the third course,CR was achieved in 32 out of 79 patients,CR rate was 40. 51%(32/79),the total effective rate was 83. 54%(66/79). In the 44 patients older than 60 years,CR rate was 40. 91%(18/44),the total effective rate was 84. 09%(37/44),in the other 35 patients less than 60 years,CR rate was 40%(14/35),the total effective rate was 85. 71%(30/35),there was no significant difference between the two groups(P>0. 05). In 38 patients with IgG type,CR rate was 44. 74%(17/38),the total effective rate was 92. 11%(35/38),in 23 patients with IgA type,CR rate was 39. 13%(9/23),the total effective rate was 82. 61%(19/23),in 8 patients with light chain type,CR was 37. 50%(3/8),the total effective rate was 75. 00%(6/8),in 10 patients with no secretory type,CR rate was 30. 00%(3/10),the total effective rate was 70%(7/10). There were no significant differences among the groups( P> 0. 05). Conclusion:The regimen of thalidomide combined with modified VAD is effective on MM with acceptable side effects.